Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Medical Specialists
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
625 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-2004
(770) 422-8465
Mailing address
625 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-2004
(770) 422-8465
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
GA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
GA
Other
Enumeration date
02/08/2011
Last updated
11/18/2013
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