Wellstar Medical Group, LLC

NPI #1003112640 in Hiram, Georgia

Provider Information

NPI Number: 1003112640
Entity Type: Organization
Organization Name: Wellstar Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WELLSTAR MEDICAL GROUP, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jan 30, 2011
Last Updated: Nov 19, 2013

Practice Location

Address: 176 CHARLES HARDY PKWY
Address 2: UNIT C
City: Hiram
State: Georgia
ZIP Code: 30141-1836
Phone: (678) 945-8200

Authorized Official

Name: MRS. NICOLE ASHE
Title: EXECUTIVE DIRECTOR OF FINANCE
Phone: (470) 644-0095

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Internal Medicine	207R00000X	Primary

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