Healthcare Provider Details

I. General information

NPI: 1447234349
Provider Name (Legal Business Name): MICHAEL B FOSTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S FLOYD ST STE 403
LOUISVILLE KY
40202-1837
US

IV. Provider business mailing address

PO BOX 909
LOUISVILLE KY
40201-0909
US

V. Phone/Fax

Practice location:
  • Phone: 502-588-3400
  • Fax: 502-588-3401
Mailing address:
  • Phone: 502-588-3400
  • Fax: 502-588-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number22282
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number22282
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: