OrganizationWellstar Medical Group, Llc(<Unavail>)Family MedicineAllopathic & Osteopathic PhysiciansPractice Address2513 Shallowford Rd, Building 100, Marietta, GA 30066-6809(770) 516-3500PECOS EnrollmentBased on the most recent information from CMS, provider Wellstar Medical Group, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1871871160Provider TypeOrganizationFull NameWellstar Medical Group, LlcOther Name<Unavail>SubpartYesEnumeration Date8/3/2011Last Updated9/8/2011Contact InformationPractice LocationPractice Address2513 Shallowford Rd, Building 100, Marietta, GA 30066-6809Phone(770) 516-3500Fax(770) 516-3600Mailing LocationMailing Address2513 Shallowford Rd, Building 100, Marietta, GA 30066-6809Phone(770) 516-3500Fax(770) 516-3600Authorized OfficialNameAshe, Nicole (Executive Director Of Finance)Phone(770) 792-5261Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerGeorgia