Provider Demographics
NPI:1811952633
Name:FORBESS, LISA WEISS (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:WEISS
Last Name:FORBESS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:KAREN
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 64442
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-6444
Mailing Address - Country:US
Mailing Address - Phone:410-328-8090
Mailing Address - Fax:410-328-9191
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-7877
Practice Address - Fax:410-328-2062
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD90877207RC0000X
MDD0090877207RA0002X
FLME163986207RA0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart Disease
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170011401Medicaid
G99061Medicare UPIN