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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Pediatrics at Johnson Square
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
3939 ROSWELL RD, SUITE 300, MARIETTA, GA 30062-6251
(770) 509-1234
(770) 509-1235
Mailing address
3939 ROSWELL RD, SUITE 300, MARIETTA, GA 30062-6251
(770) 509-1234
(770) 509-1235

Taxonomy

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

Other

Enumeration date
02/25/2013
Last updated
05/26/2015
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