Provider Demographics
NPI:1245599026
Name:FOSTER MEDICAL CARE LLC
Entity type:Organization
Organization Name:FOSTER MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMALA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-330-3541
Mailing Address - Street 1:501 N FREDERICK AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2507
Mailing Address - Country:US
Mailing Address - Phone:301-330-3541
Mailing Address - Fax:301-990-1381
Practice Address - Street 1:501 N FREDERICK AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2507
Practice Address - Country:US
Practice Address - Phone:301-330-3541
Practice Address - Fax:301-990-1381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0060314207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty