Wellstar Medical Group, LLC

NPI #1790081362 in Austell, Georgia

Provider Information

NPI Number: 1790081362
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 31, 2011
Last Updated: Nov 19, 2013

Practice Location

Address: 1790 MULKEY RD
Address 2: SUITE 5-A
City: Austell
State: Georgia
ZIP Code: 30106-1122
Phone: (770) 732-1055

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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