Provider Demographics
NPI:1710410253
Name:FOSTER, SCOTT CRANDALL (PT, DPT, OCS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:CRANDALL
Last Name:FOSTER
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8322 BELLONA AVE
Mailing Address - Street 2:SUITE # 100
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2065
Mailing Address - Country:US
Mailing Address - Phone:410-337-7900
Mailing Address - Fax:410-769-8591
Practice Address - Street 1:201 PLUMTREE RD
Practice Address - Street 2:SUITE # 301
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6053
Practice Address - Country:US
Practice Address - Phone:410-569-8587
Practice Address - Fax:410-569-3551
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD263242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD26324OtherPT LICENSE