Provider Demographics
NPI:1063486405
Name:WEST, FORREST (MD)
Entity Type:Individual
Prefix:DR
First Name:FORREST
Middle Name:
Last Name:WEST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7 SCHOOL ST
Mailing Address - Street 2:STE 1 LOVEJOY HEALTH CENTER
Mailing Address - City:ALBION
Mailing Address - State:ME
Mailing Address - Zip Code:04910
Mailing Address - Country:US
Mailing Address - Phone:207-437-9388
Mailing Address - Fax:207-437-2557
Practice Address - Street 1:7 SCHOOL ST
Practice Address - Street 2:STE 1 LOVEJOY HEALTH CENTER
Practice Address - City:ALBION
Practice Address - State:ME
Practice Address - Zip Code:04910
Practice Address - Country:US
Practice Address - Phone:207-437-9388
Practice Address - Fax:207-437-2557
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME008711207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME310160099Medicaid
ME080060209OtherRAILROAD MEDICARE
ME310160099Medicaid
ME080060209Medicare PIN
MEMM4049Medicare ID - Type Unspecified