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General NPI Number Information
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NPI Number | 1740654284
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Entity Type | Organization
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Legal Business Name | WELLSTAR HEALTH SYSTEM
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Dates
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Enumeration Date | 11/20/2015
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 3950 AUSTELL RD
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City | AUSTELL
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State | GA
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Zip | 30106-1121
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Country | US
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Telephone | 470-732-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 1800 PARKWAY PL SE STE 500
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City | MARIETTA
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State | GA
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Zip | 30067-8237
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Country | US
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Telephone | 470-956-4981
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Fax |
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Authorized Official
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Title or Position | EVP
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Name | ANTHONY J BUDZINSKI
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Credential | NP
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Telephone | 470-956-4981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | F1015620
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License Number State | GA
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