Wellstar Medical Group, LLC

NPI #1346593316 in Canton, Georgia

Provider Information

NPI Number: 1346593316
Entity Type: Organization
Organization Name: Wellstar Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WELLSTAR MEDICAL GROUP, LLC
Primary Specialty: Family Medicine
Enumeration Date: Oct 16, 2012
Last Updated: Jun 8, 2015

Practice Location

Address: 3755 SIXES RD
Address 2: SUITE 202
City: Canton
State: Georgia
ZIP Code: 30114-7842
Phone: (770) 720-1880

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	Primary

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