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WELLSTAR CARDIOVASCULAR MEDICINE LLC NPI 1457320319


NPI Information

NPI: 1457320319
Provider Name: WELLSTAR CARDIOVASCULAR MEDICINE, LLC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
55 WHITCHER ST NE
SUITE 350
MARIETTA, GA
ZIP 30060
Phone: (770) 424-6893
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WELLSTAR CARDIOVASCULAR MEDICINE, LLC is a cardiovascular disease internal medicine in Marietta, GA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. WELLSTAR CARDIOVASCULAR MEDICINE, LLC NPI is 1457320319. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

55 WHITCHER ST NE
SUITE 350
MARIETTA, GA
ZIP 30060-155
Phone: (770) 424-6893
Fax: (770) 528-9938

The provider's authorized official is Barry D Mangel .
The authorized official title is Chief Cardiology Officer and has the following contact phone number (770) 424-6893.

The enumeration date for this NPI number is 3/14/2006 and was last updated on 5/9/2012.


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
1207RI0011XInternal MedicineInterventional CardiologyNo
2207RC0001XInternal MedicineClinical Cardiac ElectrophysiologyNo
3207RC0000XInternal MedicineCardiovascular DiseaseYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1511G701144MEDICARE PINGEORGIA
2386693863AMEDICAIDGEORGIA

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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