Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar General Surgery (Canton Road)
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
800 CANTON RD NE, MARIETTA, GA 30060-7260
(770) 424-4328
(770) 426-9924
Mailing address
800 CANTON RD NE, MARIETTA, GA 30060-7260
(770) 424-4328
(770) 426-9924
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
GA
Other
Enumeration date
09/17/2013
Last updated
04/30/2014
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