Individual
WALTER H FORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
733 US HIGHWAY 1 BLDG 2B, NORTH PALM BEACH, FL 33408-4513
(561) 841-8588
(561) 841-8533
Mailing address
733 US HIGHWAY 1 BLDG 2B, NORTH PALM BEACH, FL 33408-4513
(561) 841-8588
(561) 841-8533
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME17928
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054676300
—
FL
01
—
300060057
RAILROAD MEDICARE
FL
01
—
50884
BLUE CROSS BLUE SHIELD
FL
01
—
990105
NEIGHBORHOOD HEALTH
FL
01
—
N272625
WELLCARE
FL
Enumeration date
01/17/2007
Last updated
05/24/2012
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