OrganizationActive
Wellstar Medical Group, LLC
NPI 1356736250 · Child Abuse Pediatrics Physician · Marietta, GA
Provider details
- NPI number
- 1356736250
- Entity type
- Organization
- Primary specialty
- Child Abuse Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Wellstar Medical Group, LLC
- Organization subpart
- Yes
- Authorized official
- Nicole Ashe, Executive Director of Finance(470) 644-0095
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
736 Whitlock Ave Nw
Suite 600
Marietta, GA 30064-0001
Phone: (770) 801-3465
Fax: (770) 801-3465
Approximate (ZIP-level) locationGet directions
Mailing address
736 Whitlock Ave Nw
Marietta, GA 30064-0001
Other names (DBA / former)
- Doing business as
- Wellstar Safepath Childrens Advocacy Center
Registry dates
- Enumerated
- 2015-03-30
- Last updated
- 2015-09-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.