Provider Demographics
NPI:1922115476
Name:FORSTER, JAMES W (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:FORSTER
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:P.O. BOX 523146
Mailing Address - Street 2:
Mailing Address - City:MARATHON SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33052-3146
Mailing Address - Country:US
Mailing Address - Phone:305-289-1227
Mailing Address - Fax:305-743-3969
Practice Address - Street 1:8151 OVERSEAS HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3200
Practice Address - Country:US
Practice Address - Phone:305-289-1227
Practice Address - Fax:305-743-3969
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLM0024676174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL44108Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
FLD54880Medicare UPIN