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General NPI Number Information
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NPI Number | 1497616742
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Entity Type | Organization
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Legal Business Name | WELLSTAR MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 1000 TECHNOLOGY WAY SUITE 1107
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City | MARIETTA
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State | GA
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Zip | 30060
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Country | US
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Telephone | 470-578-6644
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Fax | 470-578-9205
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Provider Business Mailing Address
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Address Line | 793 SAWYER ROAD
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City | MARIETTA
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State | GA
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Zip | 30062
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MRS. CHHAVI NOOHANI
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Credential | DO
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Telephone | 470-578-6644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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