Provider Demographics
NPI:1235104787
Name:FOSTER, RAYMOND TODD SR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:TODD
Last Name:FOSTER
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7687
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-7687
Mailing Address - Country:US
Mailing Address - Phone:573-882-2259
Mailing Address - Fax:
Practice Address - Street 1:500 N KEENE ST
Practice Address - Street 2:SUITE 306
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8370
Practice Address - Country:US
Practice Address - Phone:573-817-3165
Practice Address - Fax:573-875-9260
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006028223207V00000X, 207VF0040X
NC200400860207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO204456305Medicaid
MO891366PMedicaid
MOI10597Medicare UPIN
MO2029686Medicare ID - Type Unspecified
MO204456305Medicaid
MO891366PMedicaid
MO968911938Medicare PIN