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Individual
MR. SCOTT IAN FORMAN
Active
Individual
MR. SCOTT IAN FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
05012386
PA
208M00000X
Hospitalist Physician
Primary
OS012386
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101139948000
—
PA
01
—
1623935
BLUE SHIELD
PA
Enumeration date
07/29/2005
Last updated
07/13/2026
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