Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Infectious Disease
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
55 WHITCHER ST NE, SUITE 220, MARIETTA, GA 30060-1155
(770) 429-0083
(770) 425-0137
Mailing address
55 WHITCHER ST NE, SUITE 220, MARIETTA, GA 30060-1155
(770) 429-0083
(770) 425-0137
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
GA
207RI0200X
Infectious Disease Physician
Primary
—
GA
Other
Enumeration date
06/10/2011
Last updated
11/18/2013
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