Wellstar Medical Group, LLC

NPI #1912203050 in Douglasville, Georgia

Provider Information

NPI Number: 1912203050
Entity Type: Organization
Organization Name: Wellstar Medical Group, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: WELLSTAR MEDICAL GROUP, LLC
Primary Specialty: Pediatrics
Enumeration Date: Feb 8, 2011
Last Updated: Nov 19, 2013

Practice Location

Address: 6095 PROFESSIONAL PKWY
Address 2: SUITE 100
City: Douglasville
State: Georgia
ZIP Code: 30134-5607
Phone: (770) 920-2255

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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