Provider Demographics
NPI:1417092347
Name:FORBES, PEGGY MARRIOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:MARRIOTT
Last Name:FORBES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAM
Other - Middle Name:
Other - Last Name:FORBES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1115 UPPER HEMBREE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0913
Mailing Address - Country:US
Mailing Address - Phone:770-475-1993
Mailing Address - Fax:
Practice Address - Street 1:1115 UPPER HEMBREE RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0913
Practice Address - Country:US
Practice Address - Phone:770-475-1993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0327322084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF68039Medicare UPIN