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WELLSTAR MEDICAL GROUP LLC NPI 1255633004


NPI Information

NPI: 1255633004
Provider Name: WELLSTAR MEDICAL GROUP, LLC

Doing Business As: WELLSTAR FAMILY MEDICINE EC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2020885

Address:
3747 ROSWELL RD NE
SUITE 216
MARIETTA, GA
ZIP 30062
Phone: (770) 973-2272
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WELLSTAR MEDICAL GROUP, LLC is a family medicine in Marietta, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WELLSTAR MEDICAL GROUP, LLC NPI is 1255633004. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Wellstar Family Medicine Ec.

The provider's business location address is:

3747 ROSWELL RD NE
SUITE 216
MARIETTA, GA
ZIP 30062-234
Phone: (770) 973-2272
Fax: (770) 973-9245

The provider's authorized official is Nicole Ashe .
The authorized official title is Executive Vp Of Finance and has the following contact phone number (470) 644-0095.

The CLIA number assigned to this NPI record is 11D2020885 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/30/2010 and was last updated on 6/8/2015.


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
1207Q00000XFamily MedicineYes

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: 4/28/2024

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