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Contact Information

WELLSTAR MEDICAL GROUP, LLC
677 CHURCH ST NE
MARIETTA, GA30060-1101
 Phone: 770-793-6695
 Fax: 770-793-7997
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for WELLSTAR MEDICAL GROUP LLC · (Female)

NPI Number 1689967697
Status Active
Credentials
Entity Individual
Enumeration date 05/24/2011
Last updated 11/18/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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