Provider Demographics
NPI:1942591979
Name:FORBES, PETER JOHN
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JOHN
Last Name:FORBES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 HANDON LN
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-1252
Mailing Address - Country:US
Mailing Address - Phone:704-225-3248
Mailing Address - Fax:
Practice Address - Street 1:3716 W WT HARRIS BLVD STE J
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-8517
Practice Address - Country:US
Practice Address - Phone:704-598-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18107183500000X
AZ13234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist