Provider Demographics
NPI:1053474502
Name:FOSTER, ANDRA SCHMIDT (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDRA
Middle Name:SCHMIDT
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5313 BALFOR DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-2406
Mailing Address - Country:US
Mailing Address - Phone:757-490-2273
Mailing Address - Fax:747-490-6001
Practice Address - Street 1:505 S INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1150
Practice Address - Country:US
Practice Address - Phone:757-490-2273
Practice Address - Fax:757-490-6001
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001244111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVA0104001244OtherVIRGINIA LICENSE NUMBER
VA1053474502OtherNPI (PRACTICE)
VA179704OtherANTHEM PROVIDER NUMBER
VA179704OtherANTHEM PROVIDER NUMBER