Provider Demographics
NPI:1306223250
Name:EMERGENCY MD CONSULTANT LLC
Entity Type:Organization
Organization Name:EMERGENCY MD CONSULTANT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARKUS
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSYTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-737-1492
Mailing Address - Street 1:7320 W HOOD PL
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7320 W HOOD PL
Practice Address - Street 2:SUITE 101
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7721
Practice Address - Country:US
Practice Address - Phone:509-737-1492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-29
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty