Organization · Type 2 NPI

Wellstar Medical Group, LLC

Radiation Oncology Physician · Marietta, GA

NPI number 1184990145 Active

Practice location

320 Kennestone Hospital Blvd, Suite LL1
Marietta, GA 30060-1161

Fax (770) 793-7985

Specialties and licenses

Taxonomy	Code	License
Radiation Oncology Physician Primary	2085R0001X	None listed

Radiation Oncology Physician: A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

15 other providers at this address

NPI record

NPI: 1184990145
Entity type: Organization (Type 2)
Issued: Mar 23, 2012
Last updated: Nov 19, 2013
Status: Active
Subpart: Yes of Wellstar Medical Group, LLC

Other names

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Wellstar Radiation Oncology · doing business as

Authorized official

Mrs. Nicole Ashe
Executive Director of Finance
(470) 644-0095

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1184990145

Wellstar Medical Group, LLC's National Provider Identifier is 1184990145, issued on Mar 23, 2012. The primary taxonomy on file is Radiation Oncology Physician (2085R0001X), and the practice location is in Marietta, GA. The record was last updated on Nov 19, 2013.