O'Shane Lemar Forsythe
Individual provider Active NPI Driver · Winston Salem, NC
NPI 1174174155 · NPPES record last updated Sep 22, 2019
Key facts
- NPI
- 1174174155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 000030993837 (NC)
- Practice address
- 3519 Chelsea Manor Dr
Winston Salem, NC 27103-1585 - Phone
- (336) 501-4085
- NPI assigned
- Sep 22, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000030993837 | NC | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 000030993837 | NC | Yes |
Addresses
Primary practice location
3519 Chelsea Manor Dr
Winston Salem, NC 27103-1585
Mailing address
3519 Chelsea Manor Dr
Winston Salem, NC 27103-1585
Phone (336) 501-4085
Other providers in Winston Salem, NC
- Forsyth Radiological Associates
- Forsyth Surgical Associates
- Forsyth Transportation Services
- Forsyth Village
- Forsythe Memorial Hospital, Inc
- Leslie Fort-Barrie
- Christopher John Fort
- Fortitude Counseling Services
- Matthew Fortune
- Ashlyn Foskey
All providers in Winston Salem, NC · Driver in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.