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General NPI Number Information
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NPI Number | 1720287188
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Entity Type | Organization
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Legal Business Name | WELLSTAR RHEUMATOLOGY ASSOCIATES OF MARIETTA, LLC
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 700 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-7220
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Country | US
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Telephone | 770-420-1690
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Fax |
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Provider Business Mailing Address
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Address Line | 700 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-7220
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Country | US
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Telephone | 770-420-1690
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR OF FINANCE
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Name | NICOLE ASHE
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Credential |
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Telephone | 770-792-5261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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