Provider Demographics
NPI:1750666798
Name:MEDSITE HEALTH MANAGEMENT
Entity Type:Organization
Organization Name:MEDSITE HEALTH MANAGEMENT
Other - Org Name:HEALTHSTAT INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-529-6161
Mailing Address - Street 1:4601 CHARLOTTE PARK DR STE 390
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-1900
Mailing Address - Country:US
Mailing Address - Phone:704-529-6161
Mailing Address - Fax:704-936-5570
Practice Address - Street 1:4601 CHARLOTTE PARK DR STE 390
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1900
Practice Address - Country:US
Practice Address - Phone:704-529-6161
Practice Address - Fax:704-936-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty