Basic Information
Provider Information
NPI: 1437544723
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FORTE
FirstName: MICHAEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 STADIUM DR
Address2:  
City: MORGANTOWN
State: WV
PostalCode: 265067911
CountryCode: US
TelephoneNumber: 3045984850
FaxNumber: 3045984871
Practice Location
Address1: 75 ARCH ST STE 501
Address2:  
City: AKRON
State: OH
PostalCode: 443041434
CountryCode: US
TelephoneNumber: 3303199700
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/02/2015
LastUpdateDate: 08/24/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/24/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RP1001X35.141572OHY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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