Individual
DR. ANGELIQUE STACEY ANN FORRESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
420 POLIFKA DR BLDG 1042, SHAW AFB, SC 29152-5100
(038) 956-2458
Mailing address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME142708
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/21/2017
Last updated
02/23/2026
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