Individual
NOVA MICHELE FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1237 E MAIN ST, SUITE C, CARBONDALE, IL 62901-3148
(618) 457-2281
(618) 529-0573
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 457-5200
(618) 351-6486
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036.134717
IL
208600000X
Surgery Physician
A65913
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A659130
—
CA
Enumeration date
07/25/2006
Last updated
04/18/2014
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