Provider Demographics
NPI:1477217578
Name:FORSYTHE, DAWN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:
Last Name:FORSYTHE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5309 DISCOVERY PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2789
Mailing Address - Country:US
Mailing Address - Phone:757-914-6353
Mailing Address - Fax:
Practice Address - Street 1:5309 DISCOVERY PARK BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2789
Practice Address - Country:US
Practice Address - Phone:757-914-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist