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Individual

LEA ROSE FOSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-8800
Mailing address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-8100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0007670
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1176945
NCCPA
01
C0007670
MARYLAND BOARD OF PHYSICIANS
MD
Enumeration date
10/07/2020
Last updated
01/28/2021
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