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General NPI Number Information
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NPI Number | 1275521163
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Entity Type | Individual
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Provider Name | THOMAS R FOSTER MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 709 S HARBOR CITY BLVD SUITE 100
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City | MELBOURNE
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State | FL
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Zip | 32901-1938
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Country | US
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Telephone | 321-722-0423
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Fax | 866-747-3794
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Provider Business Mailing Address
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Address Line | 709 S HARBOR CITY BLVD SUITE 100
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City | MELBOURNE
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State | FL
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Zip | 32901-1938
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Country | US
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Telephone | 321-722-0423
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Fax | 866-747-3794
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME57257
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License Number State | FL
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