Provider Demographics
NPI:1669489001
Name:FOSTER, ROBERT SCOTT JR (DC,CCEP)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:FOSTER
Suffix:JR
Gender:M
Credentials:DC,CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2755 LEWISVILLE CLEMMONS RD
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8715
Mailing Address - Country:US
Mailing Address - Phone:336-778-2242
Mailing Address - Fax:336-778-2252
Practice Address - Street 1:2755 LEWISVILLE CLEMMONS RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8715
Practice Address - Country:US
Practice Address - Phone:336-778-2242
Practice Address - Fax:336-778-2252
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890838TMedicaid
NC35083OtherPARTNERS MEDICARE CHOICE
NC0838TOtherBLUE CROSS BLUE SHIELD
NC0838TOtherBLUE CROSS BLUE SHIELD
NC890838TMedicaid