Provider Demographics
NPI:1750356010
Name:FOSTER, IAN SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:SCOTT
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:BUTTERMILK FALLS RD.
Mailing Address - City:SHAWNEE ON DELAWARE
Mailing Address - State:PA
Mailing Address - Zip Code:18356-0244
Mailing Address - Country:US
Mailing Address - Phone:570-421-3900
Mailing Address - Fax:570-424-1549
Practice Address - Street 1:BUTTERMILK FALLS ROAD
Practice Address - Street 2:
Practice Address - City:SHAWNEE-ON-DELAWARE
Practice Address - State:PA
Practice Address - Zip Code:18356-0244
Practice Address - Country:US
Practice Address - Phone:570-421-3900
Practice Address - Fax:570-424-1549
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031607E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA414-E105OtherGEISINGER HEALTH PLAN
PA002113OtherFIRST PRIORITY HEALTH
PA744447OtherBLUE SHIELD
PA1007575050001Medicaid
PA73400OtherUNISON
PA5999983OtherGROUP HEALTH INSURANCE
PA744447OtherBLUE SHIELD
PA73400OtherUNISON