| Michael A Forman Phd Inc | |
|
3545 Olentangy River Road Suite 214 Columbus OH 43214-3907 | |
| (614) 263-5908 | |
| (614) 263-5941 |
| Full Name | Michael A Forman Phd Inc |
|---|---|
| Speciality | Psychologist |
| Location | 3545 Olentangy River Road, Columbus, Ohio |
| Authorized Official Name and Position | Michael A Forman (PRESIDENT) |
| Authorized Official Contact | 6142635908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael A Forman Phd Inc 3545 Olentangy River Rd Suite 214 Columbus OH 43214-3907 Ph: (614) 263-5908 | Michael A Forman Phd Inc 3545 Olentangy River Road Suite 214 Columbus OH 43214-3907 Ph: (614) 263-5908 |
| NPI Number | 1508923137 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 10/09/2012 |
| Medicare PECOS PAC ID | 2668406570 |
|---|---|
| Medicare Enrollment ID | O20050920001342 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508923137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2928 (Ohio) | Primary |
| 103T00000X | Psychologist | 4417 (Ohio) | Secondary |
| Provider Name | Michael A Forman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194726133 PECOS PAC ID: 1658305560 Enrollment ID: I20120220000391 |
| Provider Name | Nancy Forman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861484172 PECOS PAC ID: 8729247788 Enrollment ID: I20120309000610 |
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