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WELLSTAR KENMAR PEDIATRICS LLC NPI 1346296746


NPI Information

NPI: 1346296746
Provider Name: WELLSTAR KENMAR PEDIATRICS, LLC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 11D0964687

Address:
760 KENNESAW AVE NW
MARIETTA, GA
ZIP 30060
Phone: (770) 427-0183
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WELLSTAR KENMAR PEDIATRICS, LLC is a pediatrics in Marietta, GA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. WELLSTAR KENMAR PEDIATRICS, LLC NPI is 1346296746. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

760 KENNESAW AVE NW
MARIETTA, GA
ZIP 30060-909
Phone: (770) 427-0183
Fax: (770) 427-0788

The provider's authorized official is Nicole Ashe .
The authorized official title is Executive Director Of Finance and has the following contact phone number (770) 792-5261.

The CLIA number assigned to this NPI record is 11D0964687 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 7/14/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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