Provider Demographics
NPI:1760588842
Name:FOSTER, KEVIN L (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:L
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:801 MEDICAL DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3654
Mailing Address - Country:US
Mailing Address - Phone:636-327-3100
Mailing Address - Fax:636-639-5132
Practice Address - Street 1:801 MEDICAL DR
Practice Address - Street 2:SUITE 400
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-3654
Practice Address - Country:US
Practice Address - Phone:636-327-3100
Practice Address - Fax:636-639-5132
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MODOR8N84207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF53755Medicare UPIN