Individual
DR. PATRICIA R FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16 W LONG ST, COLUMBUS, OH 43215-2815
(614) 225-0990
(614) 225-0988
Mailing address
16 W LONG ST, COLUMBUS, OH 43215-2815
(614) 225-0990
(614) 225-0988
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-04-4652
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0421134
—
OH
Enumeration date
10/13/2006
Last updated
07/18/2022
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