NPIMap

Individual provider Active NPI

Michael Scott Forman, BS IN PHARMACY

  • Pharmacist
  • Baltimore, MD
National Provider Identifier
1154324556
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
19489 Issued in MA
Practice address
7500 Security Blvd
Mail Stop: C1-22-06
Baltimore, MD 21244-1849
Phone
(410) 786-2666
Fax
(410) 786-0486
NPI assigned
May 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19489 MA Primary
Pharmacist 183500000X RP035829R PA

Addresses

Primary practice location

7500 Security Blvd
Mail Stop: C1-22-06
Baltimore, MD 21244-1849

Mailing address

7500 Security Blvd
Mail Stop: C1-22-06
Baltimore, MD 21244-1849
Phone (410) 786-2666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
19489MAMDGeneral Practice Dentistry
RP035829RPAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1154324556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 SECURITY BLVD",
            "address_2": "MAIL STOP: C1-22-06",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212441849",
            "telephone_number": "410-786-2666",
            "fax_number": "410-786-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 SECURITY BLVD",
            "address_2": "MAIL STOP: C1-22-06",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212441849",
            "telephone_number": "410-786-2666",
            "fax_number": "410-786-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "BS IN PHARMACY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "19489",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP035829R",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.