Provider Demographics
NPI:1356336655
Name:FOSTER, JOHN I III (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:I
Last Name:FOSTER
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:5555 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1703
Mailing Address - Country:US
Mailing Address - Phone:770-455-4009
Mailing Address - Fax:770-455-4065
Practice Address - Street 1:5555 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 215
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1703
Practice Address - Country:US
Practice Address - Phone:770-455-4009
Practice Address - Fax:770-455-4065
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2012-08-09
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Provider Licenses
StateLicense IDTaxonomies
GA037539207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20NCCDZMedicare ID - Type Unspecified
GAG42718Medicare UPIN