Provider Demographics
NPI:1265422513
Name:FORUM HEALTH ENTERPRISES
Entity type:Organization
Organization Name:FORUM HEALTH ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NEUROLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:AMARJEET
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAGPAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-726-5500
Mailing Address - Street 1:PO BOX 1113
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44501-1113
Mailing Address - Country:US
Mailing Address - Phone:330-884-1000
Mailing Address - Fax:
Practice Address - Street 1:755 BOARDMAN CANFIELD RD
Practice Address - Street 2:BLDG P SUITE#1
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4300
Practice Address - Country:US
Practice Address - Phone:330-726-5500
Practice Address - Fax:330-726-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-0484204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35-04-0484OtherLICENSE
OH03522292Medicaid
OH35-04-0484OtherLICENSE