Individual
FORREST T CLOSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
650 W LOMBARD ST, BALTIMORE, MD 21201-1513
(410) 328-2079
(410) 328-0987
Mailing address
PO BOX 62063, BALTIMORE, MD 21264-2063
(410) 706-5181
(410) 706-5103
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
D57752
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
769802000
—
MD
Enumeration date
06/07/2006
Last updated
07/10/2008
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