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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar SafePath Childrens Advocacy Center
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
736 WHITLOCK AVE NW, SUITE 600, MARIETTA, GA 30064-0001
(770) 801-3465
(770) 801-3465
Mailing address
736 WHITLOCK AVE NW, SUITE 600, MARIETTA, GA 30064-0001
(770) 801-3465
(770) 801-3465

Taxonomy

Speciality
Code
Description
License number
State
2080C0008X
Child Abuse Pediatrics Physician
Primary
GA

Other

Enumeration date
03/30/2015
Last updated
09/30/2015
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