Provider Demographics
NPI:1164490983
Name:FOSTER, TIMOTHY EARLE (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:EARLE
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2000 WASHINGTON ST
Mailing Address - Street 2:SUITE 423
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1650
Mailing Address - Country:US
Mailing Address - Phone:617-219-1280
Mailing Address - Fax:617-219-1281
Practice Address - Street 1:2000 WASHINGTON ST
Practice Address - Street 2:SUITE 423
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1650
Practice Address - Country:US
Practice Address - Phone:617-219-1280
Practice Address - Fax:617-219-1281
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA71005207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAF21878Medicare UPIN