Healthcare Provider Details

I. General information

NPI: 1912650615
Provider Name (Legal Business Name): HEALTHSTAT ONSITE CLINIC-MARSH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S CENTENNIAL ST
HIGH POINT NC
27260-7850
US

IV. Provider business mailing address

10 W MARKET ST STE 2900
INDIANAPOLIS IN
46204-2964
US

V. Phone/Fax

Practice location:
  • Phone: 336-660-2030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RILEY WENDLING
Title or Position: CENTRAL SUPPORT SPECIALIST
Credential:
Phone: 629-266-1080