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Wellstar Medical Group, LLC

Organization Active NPI Endocrinology, Diabetes & Metabolism Physician · Marietta, GA

NPI 1790189983 · NPPES record last updated Oct 16, 2014

Key facts

NPI
1790189983
Entity type
Organization (NPI type 2)
Primary specialty
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Practice address
355 Tower Rd NE
1St Floor
Marietta, GA 30060-9408
Phone
(470) 644-0029
Fax
(770) 499-0352
NPI assigned
Oct 16, 2014
Organization subpart
Yes
Parent organization (as reported)
WELLSTAR MEDICAL GROUP, LLC

Authorized official

Name
Mrs. Nicole Ashe
Title
Executive Director of Finance
Phone
(470) 644-0095

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Wellstar Medical Group LLC (125 organizations share this tax ID)
Part of
Wellstar Medical Group LLC

Locations

355 Tower Rd NE
Fl 1
Marietta, GA 30060
Phone (470) 644-0029

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X GA
Endocrinology, Diabetes & Metabolism Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RE0101X GA Yes

Addresses

Primary practice location

355 Tower Rd NE
1St Floor
Marietta, GA 30060-9408

Mailing address

355 Tower Rd NE
1St Floor
Marietta, GA 30060-9408
Phone (470) 644-0029

Other names

  • WellStar Complex Care Clinic Doing business as

Other providers in Marietta, GA

All providers in Marietta, GA · Endocrinology, Diabetes & Metabolism Physician in Georgia

Sources for this page

Verify at the official NPI Registry.