Healthcare Provider Details

I. General information

NPI: 1861011058
Provider Name (Legal Business Name): JUSTIN CHEW FORSYTH MB, BCH, BAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 CHESTNUT RIDGE RD
MORGANTOWN WV
26505-2807
US

IV. Provider business mailing address

930 CHESTNUT RIDGE RD
MORGANTOWN WV
26505-2807
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-4214
  • Fax:
Mailing address:
  • Phone: 304-598-4214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35126
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number13814597-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: