Matthew Charles Agan (NPI# 1013250679, PAC ID# 9436403672) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEUROLOGY.
| Nation Provider ID (NPI) | 1013250679 |
| PAC ID by PECOS | 9436403672 |
| Professional Enrollment ID | I20181107000802 |
| Full Name | Matthew Charles Agan |
| Organization Legal Name | WELLSTAR MEDICAL GROUP, LLC |
| Address |
780 Canton Rd Ne Suite 400 Marietta GA 30060-7298 |
| Phone Number | 7704223602 |
| Gender | M |
| Medical School | EMORY UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2013 |
| Primary Specialty | NEUROLOGY |
| Group Practice PAC ID | 6709065402 |
| Number of Group Practice Members | 1320 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110035 | WELLSTAR KENNESTONE HOSPITAL |
| 110143 | WELLSTAR COBB HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 780 Canton Rd Ne, Suite 400, Marietta, GA 30060-7298 | 7704223602 | WELLSTAR MEDICAL GROUP, LLC |
| Organization Legal Name | WELLSTAR MEDICAL GROUP, LLC |
| Physicians | 1338 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phong Hoang Do | Family Medicine | Wellstar Medical Group, LLC | 5150 Stilesboro N W Rd, Suite 220, Kennesaw, GA 30152-7742 |
| Francheska Desravines Alcide | Family Medicine | Wellstar Medical Group, LLC | 687 Marietta Hwy, Canton, GA 30114-2608 |
| Marcus J Gates | Neurosurgery | Wellstar Medical Group, LLC | 625 Church Nest, Marietta, GA 30060-1101 |
| Nimota A Adeboye | Nurse Practitioner | Wellstar Medical Group, LLC | 3886 Princeton Lakes Way Sw, Atlanta, GA 30331-5511 |
| Vanessa Jill Lancaster | Nurse Practitioner | Wellstar Medical Group, LLC | 1360 Upper Hembree Rd, Roswell, GA 30076-1230 |
| Janna Williams-pitts | Psychologist, Clinical | Wellstar Medical Group, LLC | 3805 Cherokee Nwst, Kennesaw, GA 30144-2085 |
| Abhishek Kumar Singh | Family Medicine | Wellstar Medical Group, LLC | 121 Marble Mill N W Rd, Suite 101, Marietta, GA 30060-7959 |
| Khuram Ashraf | Internal Medicine | Wellstar Medical Group, LLC | 6043 Prestley Mill Rd C, Douglasville, GA 30134-2280 |
| Jonathan Noel Dodd | Psychologist, Clinical | Wellstar Medical Group, LLC | 3939 Roswell Rd, Marietta, GA 30062-6285 |
| Kaushang Gandhi | Cardiovascular Disease (cardiology) | Wellstar Medical Group, LLC | 4441 Atlanta Rd Se, Suite 216, Smyrna, GA 30080-6537 |
| Street Address |
780 CANTON RD NE SUITE 400 |
| City | MARIETTA |
| State | GA |
| Zip | 30060-7298 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura Ashley Ray | General Surgery | Georgia Breast Care, P.C. | 780 Canton Rd Ne, Suite 410, Marietta, GA 30060-7298 |
| Joseph T Hormes Jr. | Neurology | Wellstar Medical Group, LLC | 780 Canton Rd Ne, Suite 400, Marietta, GA 30060-7298 |
| Joseph T Hormes | Neurology | Wellstar Medical Group, LLC | 780 Canton Rd Ne, Suite 400, Marietta, GA 30060-7298 |
| Rhonda Wachsmuth | General Surgery | Georgia Breast Care, P.C. | 780 Canton Rd Ne, Suite 410, Marietta, GA 30060-7298 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerwanda Lavette Johnson | Nurse Practitioner | Wellstar Medical Group, LLC | 2130 Anderson Mill Rd, Marietta, GA 30060 |
| Connie Dessonville Hill | Psychologist, Clinical | 125 Church Nest, Suite 210, Marietta, GA 30060 | |
| William L. Cousins | Internal Medicine | Wellstar Medical Group, LLC | 166 Vann Nest, Marietta, GA 30060 |
| Ansley Carnes | Physician Assistant | Wellstar Medical Group, LLC | 166 Vann Nest, Marietta, GA 30060 |
| Kimberly Malejko | Physician Assistant | Wellstar Medical Group, LLC | 166 Vann Nest, Marietta, GA 30060 |
| Allyson J Underwood | Nurse Practitioner | Wellstar Medical Group, LLC | 166 Vann Nest, Marietta, GA 30060 |
| Tonette Robinson | Psychologist, Clinical | Wellstar Medical Group, LLC | 55 Whitcher St, Suite 420, Marietta, GA 30060-0000 |
| Amanda Denise Parkinson | Clinical Social Worker | Wellstar Medical Group, LLC | 55 Whitcher St, Suite 420, Marietta, GA 30060-0000 |
| Callie B Dunn | Psychologist, Clinical | Wellstar Medical Group, LLC | 55 Whitcher St, Suite 420, Marietta, GA 30060-0000 |
| Candace S Hunter | Clinical Psychologist | Wellstar Medical Group, LLC | 55 Whitcher St, Suite 420, Marietta, GA 30060-0000 |
| Find all physicians in zip 30060 | |||
| City | MARIETTA |
| Zip Code | 30060 |
| Specialty | NEUROLOGY |
| City + Specialty | MARIETTA + NEUROLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.