Provider Demographics
NPI:1942286331
Name:FORSYTHE, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:FORSYTHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4885 OLENTANGY RIVER RD
Mailing Address - Street 2:SUITE 2-10
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-1926
Mailing Address - Country:US
Mailing Address - Phone:614-267-7878
Mailing Address - Fax:614-267-7077
Practice Address - Street 1:4885 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 2-10
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-1926
Practice Address - Country:US
Practice Address - Phone:614-267-7878
Practice Address - Fax:614-267-7077
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-6169208000000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0486317Medicaid
OH0573129Medicare PIN
OH0486317Medicaid