Forman, Jonathan

Forman, Jonathan is an individual health care provider with primary practice located at 7711 Quarterfield Rd Suite A, Glen Burnie MD 21061-4492. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Forman, Jonathan can be contacted via phone (410) 761-5600.

Contact Information

Primary practice address
7711 Quarterfield Rd Suite A Glen Burnie MD 21061-4492
Phone: (410) 761-5600
Fax: (410) 761-5734
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D0023811 Maryland

Profile Details

NPI number 1861493926
LBN Legal business name Forman, Jonathan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Jan 24th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861493926 NPPES
Maryland Other 015650 JHHC PROVIDER NUMBER
Maryland Other 350121-03 JHHC PROVIDER NUMBER
Maryland Other 7605-0008 JHHC PROVIDER NUMBER
Maryland Other 8162106 JHHC PROVIDER NUMBER
Maryland Other 0696514 JHHC PROVIDER NUMBER
Maryland Other 80089724 JHHC PROVIDER NUMBER
Maryland Other P12535 JHHC PROVIDER NUMBER
Maryland Other 2162106 JHHC PROVIDER NUMBER
Maryland Other 4304227 JHHC PROVIDER NUMBER
Maryland Other 1275295 JHHC PROVIDER NUMBER
Maryland MEDICAID 766371400 JHHC PROVIDER NUMBER

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