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Organization

WELLSTAR PROFESSIONAL SERVICES, LLC

Active
Parent organization
WELLSTAR HEALTH SYSTEM, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
WELLSTAR HEALTH SYSTEM, INC.
Authorized official
NICOLE ASHE (EXECTUIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization

Contact information

Practice address
805 SANDY PLAINS RD, WPG-CBO, MARIETTA, GA 30066-6340
(770) 792-5278
Mailing address
805 SANDY PLAINS RD, WPG-CBO, MARIETTA, GA 30066-6340
(770) 792-5278

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
207RI0200X
Infectious Disease Physician
2080P0202X
Pediatric Cardiology Physician
2086S0129X
Vascular Surgery Physician

Other

Enumeration date
03/24/2008
Last updated
07/14/2008
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