Individual
NATHAN BENJAMIN FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
K3576
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1046328-04
CSHCN
TX
05
—
1046328-05
—
TX
01
—
8P1488
BLUE SHIELD
TX
01
—
8W7435
BLUE CROSS BLUE SHIELD
—
01
—
P00195387
RR/MEDICARE
TX
Enumeration date
03/28/2006
Last updated
04/15/2014
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