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General NPI Number Information
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NPI Number | 1538153051
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Entity Type | Individual
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Provider Name | CHARLES RICHARD FORBES III MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 103 MYRON ST STE A
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-1485
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Country | US
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Telephone | 603-960-9123
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 260 MOAK ASSOCIATES
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City | WESTBOROUGH
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State | MA
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Zip | 01581-0260
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Country | US
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Telephone | 603-960-9123
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Fax | 508-870-9793
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 41831
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License Number State | MA
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