Organization
MICHAEL E FOSTER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E FOSTER M.D. (SOLE PROPRIETOR)
(662) 420-7061
Entity
Organization
Contact information
Practice address
7580 CLARINGTON CV, SUITE 4, SOUTHAVEN, MS 38671-5657
(662) 349-5911
Mailing address
5036 GOODMAN RD, SUITE 116, OLIVE BRANCH, MS 38654-7905
(662) 420-7061
(901) 682-9998
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11681
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG6679
RR MEDICARE PIN
MS
Enumeration date
09/11/2007
Last updated
05/26/2011
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