Provider Demographics
NPI:1730166976
Name:FOREMAN, FRANK LEROY (MD)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:LEROY
Last Name:FOREMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:550 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-4108
Mailing Address - Country:US
Mailing Address - Phone:704-873-0545
Mailing Address - Fax:704-873-0546
Practice Address - Street 1:550 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4108
Practice Address - Country:US
Practice Address - Phone:704-873-0545
Practice Address - Fax:704-873-0546
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC23020207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8933086Medicaid
NC33086OtherBCBS OF NC
NC8933086Medicaid
C81106Medicare UPIN