Provider Demographics
NPI:1356390462
Name:FOSTER, WILLIAM JOSEPH JR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:FOSTER
Suffix:JR
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2207 CONCORD PIKE # 166
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-2908
Mailing Address - Country:US
Mailing Address - Phone:855-250-3937
Mailing Address - Fax:855-250-5500
Practice Address - Street 1:3401 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-5103
Practice Address - Country:US
Practice Address - Phone:215-707-3185
Practice Address - Fax:215-707-1684
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8692207W00000X
NY239580207WX0107X
DEC1-0009712207WX0107X
MDD72604207WX0107X
MI4301093303207WX0107X
CAA83251207WX0107X
PAMD443007207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA241941D9LMedicare PIN
TXH90920Medicare UPIN
TX172835405Medicaid