Provider Demographics
NPI:1518032085
Name:FOLEY, ANTHONY ERNEST (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ERNEST
Last Name:FOLEY
Suffix:
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 1:4299 EMMAJANE COURT
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440
Mailing Address - Country:US
Mailing Address - Phone:937-429-2302
Mailing Address - Fax:
Practice Address - Street 1:300 COLLEGE PARK DRIVE
Practice Address - Street 2:UNIV OF DAYTON STUDENT HEALTH CENTER
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45469-0900
Practice Address - Country:US
Practice Address - Phone:937-229-3131
Practice Address - Fax:937-229-3107
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH036125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0306216Medicaid
CO1936Medicare UPIN
OH0306216Medicaid