Provider Demographics
NPI:1720138522
Name:FORBES, BRIAN J (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:J
Last Name:FORBES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:100 EAST PENN SQUARAE
Mailing Address - Street 2:THE WANAMAKER BUILDING 9TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9538
Mailing Address - Fax:267-425-9552
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-590-2791
Practice Address - Fax:215-590-4325
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2013-03-13
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Provider Licenses
StateLicense IDTaxonomies
PAMD063683L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001753212-0001Medicaid
PA066534J5KMedicare ID - Type Unspecified
PA001753212-0001Medicaid