Provider Demographics
NPI:1730179086
Name:FORSMAN, KAREN EDNA (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:EDNA
Last Name:FORSMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:969 N MASON RD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6338
Mailing Address - Country:US
Mailing Address - Phone:314-469-3333
Mailing Address - Fax:314-469-3327
Practice Address - Street 1:969 N MASON RD
Practice Address - Street 2:SUITE 235
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6338
Practice Address - Country:US
Practice Address - Phone:314-469-3333
Practice Address - Fax:314-469-3327
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2009-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR6D15207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E81499Medicare UPIN