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NPI Code Detail

MEDICARE: DR. VANESSA R FOSTER M.D.

MEDICARE: DR. VANESSA R FOSTER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician036107274IL
2207V00000XObstetrics & Gynecology Physician01084222AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033101753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VANESSA R FOSTER M.D.
Provider Business Mailing Address
First Line : PO BOX 1430
Second Line :
City : PORTAGE
State : IN
Zip : 46368-9230
Country : US
Telephone Number : 219-763-8112
Fax Number : 219-844-9006
Provider Business Practice Location Address
First Line : 6920 INDIANAPOLIS BLVD
Second Line :
City : HAMMOND
State : IN
Zip : 46324-2206
Country : US
Telephone Number : 219-763-8112
Fax Number : 219-764-5380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 07/17/2020

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