Individual
KERRY ANDREW FORRESTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 227-3361
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35084915
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000339136
BCBS
OH
01
—
000000339136
BCBS
—
05
—
2535939
—
OH
Enumeration date
05/22/2006
Last updated
10/17/2007
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