Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 13760 | MD |
NPI | 1881614600 |
---|---|
Provider Name | Dr. Jennifer N Forshey |
First Address | Westminster, MD 21157-7098 |
Second Address | Westminster, MD 21157-7098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 21/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1011477340001 | (05) | PA |
205396 | (05) | MD |
V03207 | (02) | PA |