Provider Demographics
NPI:1851359905
Name:FOSTER, RICHARD J (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1573
Mailing Address - Country:US
Mailing Address - Phone:734-429-5448
Mailing Address - Fax:734-944-0900
Practice Address - Street 1:250 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1573
Practice Address - Country:US
Practice Address - Phone:734-429-5448
Practice Address - Fax:734-944-0900
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRF006104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0158126595OtherBCBSM
MI1033300Medicaid
MI5812659Medicare ID - Type Unspecified
MI0158126595OtherBCBSM