WALTER B FORMAN (NPI# 1417964453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417964453 |
| Entity Type | Individual |
| Full Name | WALTER B FORMAN |
| Credential | MD |
| Practice Address |
8210 Louisiana Blvd. Ne Suite C Albuquerque NM 87113-1761 |
| Practice Telephone | 5058581222 |
| Practice Fax Number | 5058581224 |
| Mailing Telephone | 5058581222 |
| Mailing Fax Number | 5058581224 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-11-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
88-168 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 00006817 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497807531 | Walter H Forman | Radiology | 733 Us Highway 1 Bldg 2b, North Palm Beach, FL 33408-4513 | 2007-01-17 |
| Street Address |
8210 LOUISIANA BLVD. NE SUITE C |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87113-1761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669451852 | Timothy D. Krenik | Physician Assistant | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2006-01-16 |
| 1649432634 | Vanessa S Rogers | Physician Assistant | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2008-06-30 |
| 1326264623 | David B Durham | Psychiatry & Neurology | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2007-04-17 |
| 1477680536 | Carol Lorraine Merovka | Family Medicine | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2007-02-27 |
| 1932261666 | Melanie A Mayo | Nurse Practitioner | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2006-12-16 |
| 1740374123 | Carmen E Montano | Internal Medicine | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2006-10-03 |
| 1568479079 | Gail Carman De La Cruz | Nurse Practitioner | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2006-08-01 |
| 1427013705 | Andrea G Weiss | Physician Assistant | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2006-04-19 |
| 1134108236 | Lakshmi Ganga | Internal Medicine | 8210 Louisiana Blvd. Ne, Suite C, Albuquerque, NM 87113-1761 | 2006-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952944613 | Wendy Valenciano Flores | Behavior Technician | 9019 Washington St Ne Building A, Albuquerque, NM 87113 | 2019-10-24 |
| 1336608504 | Southwestern Provider Services LLC | Registered Nurse | 6400 Paseo Del Norte, Albuquerque, NM 87113 | 2019-03-18 |
| 1376047795 | Anne K. Hempstead D.d.s., P.C. | Dentist | 6400 Holly Ave Ne Ste M, Albuquerque, NM 87113 | 2018-03-20 |
| 1447769518 | Ethan Grant | Behavior Technician | 8500 Washington St Ste A1, Albuquerque, NM 87113 | 2017-09-21 |
| 1215451083 | Sarah Bartlett | Behavior Technician | 8500 Washington St, Ste A1, Albuquerque, NM 87113 | 2017-08-02 |
| 1396109906 | Cathy A Walters | Specialist/Technologist | 532 Osuna Rd Ne, Albuquerque, NM 87113 | 2016-04-09 |
| 1518389824 | Esther Sanchez | Home Health Aide | 6800 Vista Del Norte Drive, 2814, Albuqerque, NM 87113 | 2014-01-07 |
| 1356775456 | Danielle Juliet Fichera | Social Worker | 315 Alameda Park Dr, Ne, Albuquerque, NM 87113 | 2013-08-26 |
| 1093053340 | Eagle Pointe Dentists and Orthodontics, LLC | Dentist | 6230 Paseo Del Norte Ne, Suite B, Albuquerque, NM 87113 | 2013-01-22 |
| 1922346428 | Keith Levitt | Anesthesiology | 8100 Wyoming Blvd Ne #712, Suite M4, Albuquerque, NM 87113 | 2013-01-18 |
| Find all providers in zip 87113 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932562360 | Gray Pearls LLC | Family Medicine | 2506 Tramway Terrace Ct Ne, Albuquerque, NM 87122-2317 | 2016-04-02 |
| 1093954448 | Housecalls Unlimited LLC | Family Medicine | 1320 Tanglewood Pl Nw, Albuquerque, NM 87120-6548 | 2009-02-09 |
| 1437258951 | Gerard Edward Muraida | Family Medicine | 5639 Jefferson St Ne, Albuquerque, NM 87109-3412 | 2006-09-21 |
| 1144232679 | William F Orr Jr. | Family Medicine | 8220 San Pedro Dr Ne Ste 300, Albuquerque, NM 87113-2476 | 2006-08-13 |
| 1659388619 | Suzanne Pinon | Family Medicine | 8400 Menaul Blvd Ne, Suite A-141, Albuquerque, NM 87112-2260 | 2006-08-02 |
| 1780605923 | David Bennahum | Family Medicine | Westside Family / Senior Health Center, 4808 Mc Mahon Blvd., Albuquerque, NM 87114 | 2006-07-22 |
| 1750377412 | Percy M Pentecost | Family Medicine | 3016 Mackland Ave Ne, Albuquerque, NM 87106-2018 | 2005-09-27 |
| 1689671174 | Joseph Mario Lovato | Family Medicine | 4425 Rio Trumperos Court Ne, Albuquerque, NM 87120-5333 | 2005-06-30 |
| 1538667068 | Lauren Harris | Family Medicine | 8100 Wyoming Blvd Ne Ste M4, Albuquerque, NM 87113 | 2018-01-30 |
| 1891984688 | Ricardo Ortega Md, LLC | Family Medicine | 5519 Rabadi Castle Ave Nw, Albuquerque, NM 87114-1412 | 2007-10-17 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87113 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.