Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Breast Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
4550 COBB PARKWAY NORTH NW, ACWORTH, GA 30101-4180
(770) 917-8142
(770) 966-8864
Mailing address
4550 COBB PARKWAY NORTH NW, ACWORTH, GA 30101-4180
(770) 917-8142
(770) 966-8864
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
GA
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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