Healthcare Provider Details

I. General information

NPI: 1497995161
Provider Name (Legal Business Name): KATIE MAE FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5509 THOMAS ST
MAPLE HEIGHTS OH
44137-3546
US

IV. Provider business mailing address

5509 THOMAS ST
MAPLE HEIGHTS OH
44137-3546
US

V. Phone/Fax

Practice location:
  • Phone: 216-326-8242
  • Fax:
Mailing address:
  • Phone: 216-326-8242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberRL009985
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: