Marc A. Forman, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD027197-L Issued in PA

Practice address

233 S. 6TH St
Philadelphia, PA 19106-3756

Phone

(215) 413-1186

NPI assigned

May 26, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274832000000",
    "number": "1063731388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 S. 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063756",
            "telephone_number": "215-413-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 S. 6TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063756",
            "telephone_number": "215-413-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MARC",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD027197-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Forman, DMD
• Andrea Dawn Forman, M.S., C.G.C.
• Evan M Forman, PH.D.
• Harvey Richard Forman, M.D.
• Kristin Forman, C.O.T.A.
• Mark S Forman, MD
• Matthew Robert Forman, PHARMD
• Scott Ian Forman, DO
• Fernanda Ann Formel
• Armand Formica, DO

• Child & Adolescent Psychiatry Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Child & Adolescent Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.