Healthcare Provider Details

I. General information

NPI: 1811952633
Provider Name (Legal Business Name): LISA WEISS FORBESS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA KAREN WEISS MD

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

PO BOX 64442
BALTIMORE MD
21264-6444
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-7877
  • Fax: 410-328-2062
Mailing address:
  • Phone: 410-328-8090
  • Fax: 410-328-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD90877
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207RA0002X
TaxonomyAdult Congenital Heart Disease Physician
License NumberD0090877
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: