Provider Demographics
NPI:1629502455
Name:FOSTER, TIMOTHY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:PAUL
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 100296
Mailing Address - Street 2:COM, DEPT OF PEDIATRICS, MEDICAL EDUCATION
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0196
Mailing Address - Country:US
Mailing Address - Phone:352-273-8234
Mailing Address - Fax:352-294-8060
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:COM, DEPT OF PEDIATRICS, MEDICAL EDUCATION
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0196
Practice Address - Country:US
Practice Address - Phone:352-273-8234
Practice Address - Fax:352-294-8060
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2023-08-09
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Provider Licenses
StateLicense IDTaxonomies
FLME1447302080P0205X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117163400Medicaid