Organization
MEDSTAT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN MARTIN (DIRECTOR)
(574) 372-7638
Entity
Organization
Contact information
Practice address
1500 PROVIDENT DR, SUITE A, WARSAW, IN 46580-3377
(574) 372-7637
Mailing address
1500 PROVIDENT DR, SUITE A, WARSAW, IN 46580-3377
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
71005240A
IN
Other
Enumeration date
12/05/2014
Last updated
12/05/2014
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