Individual
DAVID FOUTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 MEDICAL DR, WENTZVILLE, MO 63385-3421
(800) 968-6866
Mailing address
PO BOX 790129, DEPT EC, SAINT LOUIS, MO 63179-0129
(800) 968-6866
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2005006929
MO
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
2005006929
MO
207Q00000X
Family Medicine Physician
006929
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245225168
—
MO
01
—
196690
BLUE CROSS BLUE SHIELD
—
05
—
207259706
—
MO
01
—
P00260481
RAILROAD MEDICARE
—
Enumeration date
09/16/2005
Last updated
09/09/2009
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