Provider Demographics
NPI:1548216351
Name:DOSTER, TANYA ESCOBEDO (DC)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:ESCOBEDO
Last Name:DOSTER
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 1:388 MERRIMON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-1222
Mailing Address - Country:US
Mailing Address - Phone:828-236-2200
Mailing Address - Fax:828-236-2260
Practice Address - Street 1:388 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1222
Practice Address - Country:US
Practice Address - Phone:828-236-2200
Practice Address - Fax:828-236-2260
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2990111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89085C8Medicaid
NC085C8OtherBCBS PROVIDER #
NC2454244OtherGROUP # FOR PRACTICE
NC2454244OtherGROUP # FOR PRACTICE
NC89085C8Medicaid