Forman, Mitchell David

Forman, Mitchell David is an individual health care provider with primary practice located at 874 American Pacific Dr , Henderson NV 89014-8800. He recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as his primary health care specialty. Forman, Mitchell David can be contacted via phone (702) 777-4809.

Contact Information

Primary practice address
874 American Pacific Dr Henderson NV 89014-8800
Phone: (702) 777-4809
Fax: (702) 777-4822
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Rheumatology 207RR0500X 1244 Nevada

Profile Details

NPI number 1891767638
LBN Legal business name Forman, Mitchell David
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Jun 28th, 2012 - about 13 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 1891767638 NPPES
Nevada MEDICAID 1891767638
Nevada MEDICAID 100508364

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