DR. MICHELLE JENNIFER FORMAN (NPI# 1750563896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750563896 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE JENNIFER FORMAN |
| Credential | MD |
| Practice Address |
22 S Greene St Baltimore MD 21201-1544 |
| Practice Telephone | 4103283477 |
| Mailing Telephone | 4103283477 |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2012-07-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
D0070776 | MD | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790221430 | Michelle Katherine Forman | Behavior Technician | 401 W 2nd St Ste 100, Reno, NV 89503-5397 | 2017-01-18 |
| 1861425373 | Michelle Lichtstein Forman | Physical Therapist | 11356 Sea Grass Cir, Boca Raton, FL 33498-4919 | 2006-07-08 |
| 1184286015 | Michelle Mette Forman | Physical Therapist | 9990 Double R Blvd Ste 200, Reno, NV 89521-4833 | 2019-07-01 |
| Street Address |
22 S GREENE ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383063 | Malinda Daniel Duke | Nurse Practitioner | 22 S Greene St, Rm N6w84, Baltimore, MD 21201-1544 | 2005-06-01 |
| 1891396784 | Tamara Wiseman | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-11-05 |
| 1063012664 | Shawna Marie Hutton | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-11-01 |
| 1124625413 | Kerry Ann Lambert | Pharmacist | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-08 |
| 1730786104 | Joseph William Russo | Pediatrics | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-10-07 |
| 1295342327 | Leah Marie Dubose | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-23 |
| 1275147167 | Rosalynn Joy Allen | Registered Nurse | 22 S Greene St, Baltimore, MD 21201-1590 | 2020-09-08 |
| 1174137269 | Keiara Williams | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1699389858 | Caitlin Lauren Thomas | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-09-04 |
| 1639782568 | Anna Pfouts | Nurse Practitioner | 22 S Greene St, Baltimore, MD 21201-1544 | 2020-08-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
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| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235510983 | David Jinkyu Lee | Radiology | 601 N Caroline St # 3251, Baltimore, MD 21287-0006 | 2015-06-17 |
| 1639556467 | Samarth Gola | Radiology | 601 N Caroline St Ofc 3014, Baltimore, MD 21287-0006 | 2015-04-30 |
| 1386059400 | Daniel Ryan | Radiology | 600 N. Wolfe Street Phipps Bldg, Room B-100, Baltimore, MD 21287 | 2014-06-26 |
| 1538415633 | Ammar K. Al-ibraheemi | Radiology | 601 N Wolfe St Rm 3235a, Baltimore, MD 21287-0004 | 2012-07-26 |
| 1609165042 | Sunpreet Singh Tandon | Radiology | 4940 Eastern Ave Fl 1, Baltimore, MD 21224-2735 | 2011-04-06 |
| 1639476948 | Byung Chul Yoon | Radiology | 1620 Mcelderry St Apt 515, Baltimore, MD 21205 | 2011-02-23 |
| 1730484619 | Howard Allen Davidov | Radiology | 7221 Denberg Rd, Baltimore, MD 21209-1038 | 2011-01-24 |
| 1306075056 | Elnasif Arrayeh | Radiology | 601 N Caroline St # 3235a, Baltimore, MD 21287-0006 | 2009-07-02 |
| 1922234558 | Kristin K. Porter | Radiology | Radiology Department Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287-0001 | 2009-06-10 |
| 1386884302 | Elizabeth Kristine Weihe | Radiology | 601 N Caroline St # 3142, Baltimore, MD 21287-7406 | 2009-03-03 |
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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.