Basic Information
| Provider Information | |||||||||
| NPI: | 1225128515 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOUCHE | ||||||||
| FirstName: | HEYWARD | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 E MCBEE AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296012842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8645222286 | ||||||||
| FaxNumber: | 8037081370 | ||||||||
| Practice Location | |||||||||
| Address1: | 1330 TAYLOR ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292012915 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8032965433 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2006 | ||||||||
| LastUpdateDate: | 02/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 14501 | SC | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 14501 | SC | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LC0200X | 14501 | SC | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 050028876 | 01 | SC | RR MEDICARE | OTHER | 145015 | 01 | SC | SELECT HEALTH | OTHER | 2001250 | 01 | SC | CCP | OTHER | 77834 | 01 | SC | MEDCOST | OTHER | 145015 | 05 | SC | MEDICAID | 4229861 | 01 | SC | AETNA | OTHER |