Individual
COREY MICHAEL FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 17TH ST, COLUMBUS, IN 47201-5351
(812) 376-5974
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01084141A
IN
208M00000X
Hospitalist Physician
Primary
01084141A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300041145
—
IN
01
—
412840128
MEDICARE
IN
05
—
7100541550
—
KY
Enumeration date
03/23/2017
Last updated
09/06/2024
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