Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Family Medicine & Geriatric Medicine
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
3939 ROSWELL RD, SUITE 240, MARIETTA, GA 30062-6251
(678) 403-4660
(770) 971-6994
Mailing address
3939 ROSWELL RD, SUITE 240, MARIETTA, GA 30062-6251
(678) 403-4660
(770) 971-6994
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
GA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
GA
Other
Enumeration date
09/08/2011
Last updated
11/19/2013
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