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NPI Code Detail

MEDICARE: TODD FORREST DO

MEDICARE: TODD FORREST DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician3845OH

General Provider Information

NPI Number : 1831187103
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD FORREST DO
Provider Business Mailing Address
First Line : 119 CLINTON ST
Second Line :
City : MAUMEE
State : OH
Zip : 43537-2811
Country : US
Telephone Number : 419-893-8985
Fax Number : 419-893-6766
Provider Business Practice Location Address
First Line : 119 CLINTON ST
Second Line :
City : MAUMEE
State : OH
Zip : 43537-2811
Country : US
Telephone Number : 419-893-8985
Fax Number : 419-893-6766
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 01/04/2008

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Directions to “ TODD FORREST DO” Practice Location

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