Provider Demographics
NPI:1912325655
Name:RHEUMATOLOGY ASSOCIATES OF MARIETTA
Entity Type:Organization
Organization Name:RHEUMATOLOGY ASSOCIATES OF MARIETTA
Other - Org Name:WELLSTAR
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELROD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-420-1690
Mailing Address - Street 1:700 CHURCH ST NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7220
Mailing Address - Country:US
Mailing Address - Phone:770-420-1690
Mailing Address - Fax:
Practice Address - Street 1:700 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7220
Practice Address - Country:US
Practice Address - Phone:770-420-1690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA69137261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty