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General NPI Number Information
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NPI Number | 1861011058
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Entity Type | Individual
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Provider Name | JUSTIN CHEW FORSYTH MB, BCH, BAO
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Gender | Male
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 930 CHESTNUT RIDGE RD
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City | MORGANTOWN
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State | WV
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Zip | 26505-2807
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Country | US
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Telephone | 304-598-4214
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Fax |
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Provider Business Mailing Address
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Address Line | 930 CHESTNUT RIDGE RD
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City | MORGANTOWN
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State | WV
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Zip | 26505-2807
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Country | US
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Telephone | 304-598-4214
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Fax |
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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 | 35126
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number | 13814597-1205
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License Number State | UT
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