Healthcare Provider Details

I. General information

NPI: 1689657165
Provider Name (Legal Business Name): JONATHAN F MARSH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13450 N MERIDIAN ST STE 363
CARMEL IN
46032-7120
US

IV. Provider business mailing address

8330 NAAB RD STE 340
INDIANAPOLIS IN
46260-2279
US

V. Phone/Fax

Practice location:
  • Phone: 317-582-8315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01060873A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: