Graduated: 2003
NPI: 1194072405
Practice Locations (3)
WELLSTAR MEDICAL GROUP LLC
1120 15TH ST
AUGUSTA, GA 309120004
7067218623
WELLSTAR MEDICAL GROUP LLC
121 PARK CENTRAL DR, SUITE 200
COLUMBIA, SC 292036476
7067218623
PRISMA HEALTH MEDICAL GROUP-MIDLANDS
129 N WASHINGTON ST
SUMTER, SC 291504949
8037749680
Source: CMS National Downloadable File, September 2026.