Wellstar Cardiovascular Medicine, LLC

NPI #1639454408 in Jasper, Georgia

Provider Information

NPI Number: 1639454408
Entity Type: Organization
Organization Name: Wellstar Cardiovascular Medicine, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WELLSTAR HEALTH SYSTEM, INC.
Primary Specialty: Internal Medicine - Cardiovascular Disease
Enumeration Date: Oct 12, 2011
Last Updated: May 9, 2012

Practice Location

Address: 12 SAMMY MCGHEE BLVD
Address 2: SUITE 202
City: Jasper
State: Georgia
ZIP Code: 30143-7711
Phone: (770) 704-1955

Authorized Official

Name: DR. BARRY D MANGEL
Title: CHIEF CARDIOLOGY OFFICER
Phone: (770) 424-6893

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Clinical Cardiac Electrophysiology — Clinical Cardiac Electrophysiology	207RC0001X
Internal Medicine - Interventional Cardiology — Interventional Cardiology	207RI0011X
Internal Medicine - Cardiovascular Disease — Cardiovascular Disease	207RC0000X	Primary

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