WENDY L. FORMAN (NPI# 1578537684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578537684 |
| Entity Type | Individual |
| Full Name | WENDY L. FORMAN |
| Credential | M.D. |
| Practice Address |
729 Grove Ave Unit 4 Southampton PA 18966-6008 |
| Practice Telephone | 2153559634 |
| Practice Fax Number | 2153577540 |
| Mailing Telephone | 2153559634 |
| Mailing Fax Number | 2153577540 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2018-10-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
MD046342L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0016807330001 | 05 |
| Street Address |
729 GROVE AVE UNIT 4 |
| City | SOUTHAMPTON |
| State | PA |
| Zip Code | 18966-6008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003880071 | Donald K. Marcus | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2006-02-15 |
| 1932595170 | Aleksandr Yakubov | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966-6008 | 2015-04-14 |
| 1114188893 | William Camp Pace | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2008-06-24 |
| 1134315674 | Divya Sareen | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2007-09-19 |
| 1346253663 | Sreethy Saraswathy | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2006-08-15 |
| 1215943907 | Syed Ali Zaidi | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966-6008 | 2006-08-01 |
| 1730139544 | David J. Trumbore | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2006-05-11 |
| 1154396729 | Angela V. Lawton | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2006-02-17 |
| 1639143738 | George A. Poporad | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033758636 | Nancy Rubin | Speech-Language Pathologist | Nancy Rubin, 32 Brook Drive, Southampton, PA 18966 | 2019-12-30 |
| 1265970669 | Dominic Bogucki | Specialist/Technologist | 75 Meadowfield Dr, Southampton, PA 18966 | 2017-02-06 |
| 1518404359 | Amanda Phillips | Social Worker | 504 Lakeside Office Park, Suite 504, Southampton, PA 18966 | 2017-01-31 |
| 1386988830 | Sara Beth Bergman | Occupational Therapy Assistant | 1354 Hi View Drive, Southampton, PA 18966 | 2012-11-22 |
| 1326325523 | Annie Varughese | Pharmacist | 139 Lark Dr, Holland, PA 18966 | 2011-11-16 |
| 1912284993 | Christine Renee Nichols | Social Worker | 1030 Second Street Pike, Southampton, PA 18966 | 2011-11-04 |
| 1407134125 | Apex Smiles LLC | Dentist | 771 2nd Street Pike, Southampton, PA 18966 | 2011-07-29 |
| 1790092708 | The Comprehensive Learning Center, Inc. | Community/Behavioral Health | 150 James Way, Southampton, PA 18966 | 2010-09-13 |
| 1861713786 | Austin Patrick Daly | Dentist | 404 Lakeside Park, Southampton, PA 18966 | 2010-06-15 |
| 1164660015 | Andrew J Sohl | Podiatrist | 86 Buck Rd Ste 2, Southampton, PA 18966 | 2009-01-30 |
| Find all providers in zip 18966 | ||||
| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588639165 | Richard L. Tepper | Internal Medicine | 729 Grove Ave, Unit 4, Southampton, PA 18966-6008 | 2006-02-17 |
| 1003880071 | Donald K. Marcus | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2006-02-15 |
| 1881668879 | Thomas Erik Michaelson | Internal Medicine | Infectious Diseases Associates PC, 729 Grove Ave Unit 4, Southampton, PA 18966-6008 | 2006-02-15 |
| 1932595170 | Aleksandr Yakubov | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966-6008 | 2015-04-14 |
| 1659508570 | Rajeev Santiago Fernando | Internal Medicine | 325 Meeting House Ln, Building #2, Southampton, NY 11968-5087 | 2009-06-18 |
| 1114188893 | William Camp Pace | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2008-06-24 |
| 1144418799 | Sammy G Nakhla | Internal Medicine | 325 Meeting House Ln, Bldg 2 Suite 403, Southampton, NY 11968-5087 | 2007-10-09 |
| 1134315674 | Divya Sareen | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2007-09-19 |
| 1346253663 | Sreethy Saraswathy | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966 | 2006-08-15 |
| 1215943907 | Syed Ali Zaidi | Internal Medicine | 729 Grove Ave Unit 4, Southampton, PA 18966-6008 | 2006-08-01 |
| Find all providers in SOUTHAMPTON | ||||
| City | SOUTHAMPTON |
| Zip Code | 18966 |
Please comment or provide details below to improve the information on WENDY L. FORMAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.