Provider Demographics
NPI:1003826983
Name:FOSTER, LESLIE STEPHEN (DO)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:STEPHEN
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:301-777-2543
Mailing Address - Fax:301-777-2583
Practice Address - Street 1:880 N TENNESSEE AVE
Practice Address - Street 2:STE 104
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-9101
Practice Address - Country:US
Practice Address - Phone:304-596-5160
Practice Address - Fax:304-596-5161
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH0055003208100000X, 2081P2900X, 2081P2900X
WV26022081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW2660014OtherBS REGIONAL NETWORK
MDP00419966OtherRR MEDICARE MD
PA226473M0TMedicare PIN
PAP00419966OtherRR MEDICARE PA
MD60733002OtherBS TRADITIONAL
MD602LP399Medicare PIN
PA2556469OtherHIGHMARK BCBS PA POS
PA2556469OtherFREEDOM BLUE PPO
MD439603101Medicaid
2556469OtherHIGHMARK BCBS MD POS
MDH24154Medicare UPIN