Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Intensivists
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-1372
(770) 423-9651
Mailing address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-1372
(770) 423-9651
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
GA
207RP1001X
Pulmonary Disease Physician
—
GA
Other
Enumeration date
04/30/2013
Last updated
11/18/2013
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