FolioMed - Update Your Practice Information: Request an MD-ID

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	Why Update/Validate Your practice profile? Accurate information ensures you receive accurate and timely patient information from other healthcare professionals, reduces medical claims problems because of mis-identification or incomplete information, and reduces administrative time in verifying your information.

Password Request Form

Please complete the form below and we will E-mail your password to you. All information is required, with the exception of Board Lecensure Number, so that we can correctly identify your profile.


Email Address:
First Name:
Last Name:
Middle Name:
Board Licensure Number
NPI Number
Address:
City:
State: