Provider Demographics
NPI:1962451211
Name:FOSTER, CRAIG EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:EDWIN
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1185 MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-2093
Mailing Address - Country:US
Mailing Address - Phone:860-423-7558
Mailing Address - Fax:860-423-4694
Practice Address - Street 1:1185 MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-2093
Practice Address - Country:US
Practice Address - Phone:860-423-7558
Practice Address - Fax:860-423-4694
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT038330207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG34321Medicare UPIN