MEDICARE: DR. THOMAS R FOSTER MD

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	2085R0202X	Diagnostic Radiology Physician	ME57257	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01256296	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	10315	OTHER	FL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	300137587	OTHER	FL	RR MEDCARE

General Provider Information

NPI Number	:	1275521163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS R FOSTER MD

Provider Business Mailing Address
First Line	:	709 S HARBOR CITY BLVD
Second Line	:	SUITE 100
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1938
Country	:	US
Telephone Number	:	321-722-0423
Fax Number	:	866-747-3794

Provider Business Practice Location Address
First Line	:	709 S HARBOR CITY BLVD
Second Line	:	SUITE 100
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1938
Country	:	US
Telephone Number	:	321-722-0423
Fax Number	:	866-747-3794

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

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	12/30/2014

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