Provider Demographics
NPI:1285616839
Name:RABB, FORTE C (MEDICAL DOCTOR)
Entity type:Individual
Prefix:DR
First Name:FORTE
Middle Name:C
Last Name:RABB
Suffix:
Gender:M
Credentials:MEDICAL DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2801
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-2801
Mailing Address - Country:US
Mailing Address - Phone:843-705-0840
Mailing Address - Fax:843-705-0890
Practice Address - Street 1:3901 MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-4614
Practice Address - Country:US
Practice Address - Phone:843-705-0840
Practice Address - Fax:843-705-0890
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11448173000000X
SC28389174400000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No173000000XOther Service ProvidersLegal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00089614AMedicaid
GA00089614AMedicaid
SCAA23976745Medicare PIN
FLD30541Medicare UPIN
SCAA23974065Medicare PIN