Provider Demographics
NPI:1629286125
Name:FORCINA, MATTHEW SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:SCOTT
Last Name:FORCINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44850 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1326
Mailing Address - Country:US
Mailing Address - Phone:586-731-7000
Mailing Address - Fax:586-731-8610
Practice Address - Street 1:44850 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-1326
Practice Address - Country:US
Practice Address - Phone:586-731-7000
Practice Address - Fax:586-731-8610
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083690207RC0000X, 207RC0001X, 207RC0001X
NC2009-01293207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC59-12364Medicaid
NC59-12364Medicaid
NC2073826Medicare PIN