MEDICARE: DR. BRETT HUGH FOREMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QS0010X	Sports Medicine (Family Medicine) Physician	2002-00112	NC
2	207Q00000X	Family Medicine Physician	2002-00112	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1361Y	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1497700264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT HUGH FOREMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 604337
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-4337
Country	:	US
Telephone Number	:	919-238-2000
Fax Number	:	919-238-5010

Provider Business Practice Location Address
First Line	:	8300 HEALTH PARK STE 107
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27615-4731
Country	:	US
Telephone Number	:	919-238-2000
Fax Number	:	919-238-5010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	01/02/2025

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