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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Urology
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 250, MARIETTA, GA 30060-1155
(770) 428-4475
(770) 426-1499
Mailing address
55 WHITCHER ST NE, SUITE 250, MARIETTA, GA 30060-1155
(770) 428-4475
(770) 426-1499

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
GA

Other

Enumeration date
11/27/2013
Last updated
11/27/2013
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