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General NPI Number Information
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NPI Number | 1750384277
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Entity Type | Individual
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Provider Name | LISA K HEINEMEYER-FOSTER M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2005
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 68 DARST RD
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City | BEAVERCREEK
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State | OH
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Zip | 45440-3442
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Country | US
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Telephone | 937-531-0132
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Fax | 937-531-0134
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Provider Business Mailing Address
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Address Line | 68 DARST RD
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City | BEAVERCREEK
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State | OH
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Zip | 45440-3442
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Country | US
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Telephone | 937-531-0132
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Fax | 937-531-0134
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35064298H
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License Number State | OH
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