Provider Demographics
NPI:1588654164
Name:FORREST, EILEEN CARR (MD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:CARR
Last Name:FORREST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EILEEN
Other - Middle Name:MARGARET
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-658-1823
Mailing Address - Fax:603-658-1824
Practice Address - Street 1:118 PORTSMOUTH AVE BLDG D
Practice Address - Street 2:
Practice Address - City:STRATHAM
Practice Address - State:NH
Practice Address - Zip Code:03885-2487
Practice Address - Country:US
Practice Address - Phone:603-658-1823
Practice Address - Fax:603-658-1824
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH15151208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3076462Medicaid
NH3076462Medicaid