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Organization

WELLSTAR MEDICAL GROUP, LLC

Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Neurology & Headache Center
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
780 CANTON RD NE, SUITE 400, MARIETTA, GA 30060-7298
(770) 422-3602
(770) 421-6115
Mailing address
780 CANTON RD NE, SUITE 400, MARIETTA, GA 30060-7298
(770) 422-3602
(770) 421-6115

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
GA

Other

Enumeration date
03/12/2015
Last updated
07/21/2015
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