Healthcare Provider Details

I. General information

NPI: 1750423968
Provider Name (Legal Business Name): H. JOSEPH FOSTER III
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 ROCHESTER HWY STE C2
SENECA SC
29672-2463
US

IV. Provider business mailing address

501 ROCHESTER HWY STE C2
SENECA SC
29672-2463
US

V. Phone/Fax

Practice location:
  • Phone: 864-985-0808
  • Fax: 864-985-0525
Mailing address:
  • Phone: 864-985-0808
  • Fax: 864-985-0525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number108
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. HEYWARD JOSEPH FOSTER III
Title or Position: PODIATRIST
Credential: DPM
Phone: 864-985-0808