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NPI Code Detail

MEDICARE: TASHA FOUSHEE M.D.

MEDICARE:   TASHA  FOUSHEE  M.D.
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
12085R0202XDiagnostic Radiology Physician200201578NC
22085R0202XDiagnostic Radiology Physician057365GA

General Provider Information

NPI Number : 1518926062
Entity Type Code : Individual
Provider Name (Legal Business Name) : TASHA FOUSHEE M.D.
Provider Business Mailing Address
First Line : 228 SHOREWARD DR
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-5146
Country : US
Telephone Number : 919-423-9012
Fax Number :
Provider Business Practice Location Address
First Line : 228 SHOREWARD DR
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29579-5146
Country : US
Telephone Number : 919-423-9012
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 11/18/2009

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