Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 31976 | SC |
Y | 207VX0201X | Gynecologic Oncologist | 31976 | SC |
NPI | 1477781334 |
---|---|
Provider Name | Dr. Jonathan Robert Foote |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-8908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 05/09/2013 |