NPI 1174174155

O'Shane Lemar Forsythe

Practitioner Driver Winston Salem, NC

Practice location

Address: 3519 Chelsea Manor Dr, Winston Salem, NC 27103-1585
Phone: (336) 501-4085

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 000030993837 (NC)

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Registry record

NPI: 1174174155
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Sep 2019
Record last updated: 22 Sep 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.