OrganizationActive
Healthstat Onsite Clinic Ethan Allen
NPI 1396295689 · Preventive Medicine/Occupational Environmental Medicine Physician · Maiden, NC
Provider details
- NPI number
- 1396295689
- Entity type
- Organization
- Primary specialty
- Preventive Medicine/Occupational Environmental Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Warren Hutton, Coo(704) 529-6161
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
24 Salem Church Rd
Maiden, NC 28650-8363
Phone: (704) 529-6161
Approximate (ZIP-level) locationGet directions
Mailing address
4651 Charlotte Park Dr
Charlotte, NC 28217-1956
Registry dates
- Enumerated
- 2016-10-11
- Last updated
- 2016-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.