Provider Demographics
NPI:1477840742
Name:FOSTER, ANGIE EARHART (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:EARHART
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANGIE
Other - Middle Name:DAWN
Other - Last Name:EARHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:660 OFFICE PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7103
Mailing Address - Country:US
Mailing Address - Phone:314-991-3556
Mailing Address - Fax:
Practice Address - Street 1:660 OFFICE PKWY
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7103
Practice Address - Country:US
Practice Address - Phone:314-991-3556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015004430207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology