Provider Demographics
NPI:1396905584
Name:FORBUSH, CHRISTOPHER MATTHEW (DO)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:FORBUSH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1272 W MAIN ST
Mailing Address - Street 2:SUITE 503
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055
Mailing Address - Country:US
Mailing Address - Phone:220-564-1778
Mailing Address - Fax:220-564-1779
Practice Address - Street 1:1272 W MAIN ST
Practice Address - Street 2:SUITE 503
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055
Practice Address - Country:US
Practice Address - Phone:220-564-1778
Practice Address - Fax:220-564-1779
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34011822207Q00000X
OH34.011822207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0142640Medicaid
VAD000Medicare UPIN
OHH435790Medicare PIN