Organization · Type 2 NPI

Wellstar Medical Group, LLC

Gynecologic Oncology Physician · Austell, GA

NPI number 1669815817 Active

Practice location

1700 Hospital South Dr, Suite 102
Austell, GA 30106-6810

Fax (678) 398-1929

Specialties and licenses

Taxonomy	Code	License
Gynecologic Oncology Physician Primary	207VX0201X	None listed

Gynecologic Oncology Physician: An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.

70 other providers at this address

NPI record

NPI: 1669815817
Entity type: Organization (Type 2)
Issued: Apr 8, 2013
Last updated: Nov 19, 2013
Status: Active
Subpart: Yes of Wellstar Medical Group, LLC

Other names

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Wellstar Gynecologic 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 1669815817

Wellstar Medical Group, LLC's National Provider Identifier is 1669815817, issued on Apr 8, 2013. The primary taxonomy on file is Gynecologic Oncology Physician (207VX0201X), and the practice location is in Austell, GA. The record was last updated on Nov 19, 2013.