OrganizationActive
Wellstar Medical Group, LLC
NPI 1972905396 · Pediatric Anesthesiology Physician · Kennesaw, GA
Provider details
- NPI number
- 1972905396
- Entity type
- Organization
- Primary specialty
- Pediatric Anesthesiology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Wellstar Medical Group, LLC
- Authorized official
- Nicole Ashe, Executive Director of Finance
Practice location
1180 Ernest W Barrett Pkwy Nw
Suite 100
Kennesaw, GA 30144-4534
Phone: (770) 644-1274
Fax: (770) 644-1119
Mailing address
1180 Ernest W Barrett Pkwy Nw
Kennesaw, GA 30144-4534
Registry dates
- Enumerated
- 2014-09-17
- Last updated
- 2014-09-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.