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Individual

LESLIE B FORGOSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
45 10TH ST W, SAINT PAUL, MN 55102-1062
(651) 232-3000
Mailing address
45 10TH ST W, SAINT PAUL, MN 55102-1062
(651) 232-3000

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
40393
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3409300
WI
05
768317100
MN
Enumeration date
12/06/2005
Last updated
03/13/2013
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