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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Complex Care Clinic
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
355 TOWER RD NE, 1ST FLOOR, MARIETTA, GA 30060-9408
(470) 644-0029
(770) 499-0352
Mailing address
355 TOWER RD NE, 1ST FLOOR, MARIETTA, GA 30060-9408
(470) 644-0029
(770) 499-0352

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
GA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
GA

Other

Enumeration date
10/16/2014
Last updated
10/16/2014
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