Wellstar Medical Group, LLC
Surgery in Marietta, GA. Organization (NPI-2).
NPI number1124451190
StatusActive
Last updated in NPPESNov 19, 2013
Details
- NPI
- 1124451190
- Entity type
- Organization (NPI-2)
- Legal business name
- Wellstar Medical Group, LLC
- Organization subpart
- Yes
- Enumeration date
- Aug 14, 2013
- Last updated
- Nov 19, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | GA | Yes |
Other names
- Wellstar Summit Surgical (Doing Business As)
Practice location
590 Nancy St NwMarietta, GA 30060-1334
Phone 770-423-0395 · Fax 770-499-0352
Mailing address
590 Nancy St NwMarietta, GA 30060-1334
Phone 770-423-0395 · Fax 770-499-0352
Authorized official
Nicole Ashe
Executive Director Of Finance
4706440095
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