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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Pediatric Hospital Medicine
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
677 CHURCH ST NE, SUITE 100 P, MARIETTA, GA 30060-1101
(470) 793-8585
(470) 793-1970
Mailing address
677 CHURCH ST NE, SUITE 100 P, MARIETTA, GA 30060-1101
(470) 793-8585
(470) 793-1970

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
GA
208M00000X
Hospitalist Physician
Primary
GA

Other

Enumeration date
03/12/2015
Last updated
03/16/2015
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