Provider Demographics
NPI:1326047002
Name:FOSTER, JOHN H (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26861 COUNTY ROAD 26
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46517-9782
Mailing Address - Country:US
Mailing Address - Phone:574-891-2220
Mailing Address - Fax:574-295-6571
Practice Address - Street 1:26861 COUNTY ROAD 26
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46517-9782
Practice Address - Country:US
Practice Address - Phone:574-891-2220
Practice Address - Fax:574-295-6571
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002321207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000281748OtherANTHEM BCBS
MI1326047002Medicaid
IN000000540292OtherANTHEM BCBS
IN000000540292OtherANTHEM BCBS
IN000000281748OtherANTHEM BCBS
INP00441540 RR MCRMedicare PIN
IN139700EMedicare PIN
INP00040738 RR MCRMedicare PIN