Provider Demographics
NPI:1013015924
Name:FORST, PAUL EDWARD (M D)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:EDWARD
Last Name:FORST
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 CANON WAY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5762
Mailing Address - Country:US
Mailing Address - Phone:410-857-3542
Mailing Address - Fax:410-871-2876
Practice Address - Street 1:1434 PORTER ST
Practice Address - Street 2:
Practice Address - City:FORT DETRICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9210
Practice Address - Country:US
Practice Address - Phone:301-619-6917
Practice Address - Fax:301-619-7676
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD0033281207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine