Provider Demographics
NPI:1760475370
Name:FOSTER, DONALEE WILKINS (MD)
Entity Type:Individual
Prefix:
First Name:DONALEE
Middle Name:WILKINS
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DONALEE
Other - Middle Name:
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:931 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2138
Mailing Address - Country:US
Mailing Address - Phone:641-684-3000
Mailing Address - Fax:641-684-2469
Practice Address - Street 1:931 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2138
Practice Address - Country:US
Practice Address - Phone:641-684-3000
Practice Address - Fax:641-684-2469
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA29703208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0107615Medicaid
42068106029OtherJOHN DEERE HEALTH
IA51221OtherWELLMARK BCBS OF IOWA
57444OtherIOWA HEALTH SOLUTIONS
42068106029OtherJOHN DEERE HEALTH
C48061Medicare UPIN