Provider Demographics
NPI:1710012026
Name:FOSTER, ROBERT W (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:W
Last Name:FOSTER
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-2326
Mailing Address - Country:US
Mailing Address - Phone:419-782-0836
Mailing Address - Fax:419-782-0187
Practice Address - Street 1:836 E 2ND ST
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-2326
Practice Address - Country:US
Practice Address - Phone:419-782-0836
Practice Address - Fax:419-782-0187
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2568237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0026662Medicaid