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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

NPI Number 1689967697
LBN Legal business name WELLSTAR MEDICAL GROUP, LLC
Authorized official NICOLE ASHE - (EXECUTIVE DIRECTOR OF FINANCE)
Entity Organization
Organization subpart 1 Yes
Enumeration date 05/24/2011
Last updated 11/18/2013 - About 13 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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