Forman, Mervyn B.

Forman, Mervyn B. is an individual health care provider with primary practice located at 975 Johnson Ferry Rd Ne Ste 340, Atlanta GA 30342-1619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Forman, Mervyn B. can be contacted via phone (404) 256-0121.

Contact Information

Primary practice address
975 Johnson Ferry Rd Ne Ste 340 Atlanta GA 30342-1619
Phone: (404) 256-0121
Fax: (404) 843-0355
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 035873 Georgia

Profile Details

NPI number 1215027461
LBN Legal business name Forman, Mervyn B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Jan 17th, 2008 - about 17 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 1215027461 NPPES
Georgia MEDICAID 000526446D

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