| Wellstar Medical Group, Llc | |
|
3805 Cherokee St Nw Kennesaw GA 30144-2085 | |
| (770) 426-5666 | |
| (770) 426-9212 |
| Full Name | Wellstar Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3805 Cherokee St Nw, Kennesaw, Georgia |
| Authorized Official Name and Position | Nicole Ashe (EXECUTIVE DIRECTOR OF FINANCE) |
| Authorized Official Contact | 4706440095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellstar Medical Group, Llc 3805 Cherokee St Nw Kennesaw GA 30144-2085 Ph: (770) 426-5666 | Wellstar Medical Group, Llc 3805 Cherokee St Nw Kennesaw GA 30144-2085 Ph: (770) 426-5666 |
| NPI Number | 1376849919 |
|---|---|
| Provider Enumeration Date | 01/30/2011 |
| Last Update Date | 11/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376849919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Georgia) | Secondary |
| 207Q00000X | Family Medicine | (Georgia) | Primary |
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