Basic Information
Provider Information
NPI: 1477520963
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOSTER
FirstName: ZOE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 743904
Address2:  
City: ATLANTA
State: GA
PostalCode: 303743904
CountryCode: US
TelephoneNumber: 8032967320
FaxNumber: 8032967330
Practice Location
Address1: 3209 COLONIAL DR
Address2:  
City: COLUMBIA
State: SC
PostalCode: 29203
CountryCode: US
TelephoneNumber: 8034346113
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/02/2006
LastUpdateDate: 06/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X81883SCN Allopathic & Osteopathic PhysiciansFamily Medicine 
207Q00000X4301081245MIN Allopathic & Osteopathic PhysiciansFamily Medicine 
207QS0010X81863SCY Allopathic & Osteopathic PhysiciansFamily MedicineSports Medicine

ID Information
IDTypeStateIssuerDescription
81883205SC MEDICAID


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