Healthcare Provider Details

I. General information

NPI: 1851359905
Provider Name (Legal Business Name): RICHARD J FOSTER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E MICHIGAN AVE
SALINE MI
48176-1573
US

IV. Provider business mailing address

250 E MICHIGAN AVE
SALINE MI
48176-1573
US

V. Phone/Fax

Practice location:
  • Phone: 734-429-5448
  • Fax: 734-944-0900
Mailing address:
  • Phone: 734-429-5448
  • Fax: 734-944-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRF006104
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: