Provider Demographics
NPI:1568490829
Name:FOSTER, WILLIAM J (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:J
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2253 W MASON ST STE 100
Mailing Address - Street 2:PO BOX 13097
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54307-3097
Mailing Address - Country:US
Mailing Address - Phone:920-327-7000
Mailing Address - Fax:920-327-7005
Practice Address - Street 1:2253 W MASON ST STE 100
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-4706
Practice Address - Country:US
Practice Address - Phone:920-327-7000
Practice Address - Fax:920-327-7005
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI21249207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104470266Medicaid
WI180034987OtherRAILROAD
MI104289991Medicaid
WI30136900Medicaid
MI104289991Medicaid
MI104470266Medicaid