Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 095815 | OH |
NPI | 1477719896 |
---|---|
Provider Name | Dr. Scott Foster |
First Address | Crestline, OH 44827-1455 |
Second Address | Mansfield, OH 44906-3802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2008 |
Last Update Date | 29/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3127771 | (05) | OH |