Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Infectious Disease (Douglas)
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
6043 PRESTLEY MILL RD, SUITE C, DOUGLASVILLE, GA 30134-2280
(770) 920-3076
(770) 949-8969
Mailing address
6043 PRESTLEY MILL RD, SUITE C, DOUGLASVILLE, GA 30134-2280
(770) 920-3076
(770) 949-8969
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
GA
Other
Enumeration date
10/16/2012
Last updated
05/27/2015
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