Provider Demographics
NPI:1538153051
Name:FORBES, CHARLES RICHARD III (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RICHARD
Last Name:FORBES
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:MOAK ASSOCIATES
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-0260
Mailing Address - Country:US
Mailing Address - Phone:603-960-9123
Mailing Address - Fax:508-870-9793
Practice Address - Street 1:103 MYRON ST STE A
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-1485
Practice Address - Country:US
Practice Address - Phone:603-960-9123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-12
Last Update Date:2018-05-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA418312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA701909OtherTUFTS MEDICARE PREFERRED
MAB39206OtherFEDERAL BC/BS
MA15-00677OtherEVERCARE
MAB39206OtherBC/BS OF MASSACHUSETTS
MA110006321AMedicaid
MA701909OtherTUFTS
MAO177369Medicaid
MA0024616OtherNEIGHBORHOOD HEALTH PLAN
MAB39206OtherBLUE CARD
MAB39206OtherBC/BS OF MASSACHUSETTS
MAB39206OtherBLUE CARD