MEDICARE: DR. MICHEL SUSAN FOSTER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME0033804	FL

General Provider Information

NPI Number	:	1194726570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHEL SUSAN FOSTER M.D.

Provider Business Mailing Address
First Line	:	2650 BAHIA VISTA ST
Second Line	:	#308
City	:	SARASOTA
State	:	FL
Zip	:	34239-2635
Country	:	US
Telephone Number	:	941-955-5997
Fax Number	:	941-955-5971

Provider Business Practice Location Address
First Line	:	2650 BAHIA VISTA ST
Second Line	:	#308
City	:	SARASOTA
State	:	FL
Zip	:	34239-2635
Country	:	US
Telephone Number	:	941-955-5997
Fax Number	:	941-955-5971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/09/2007

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