Provider Demographics
NPI:1457146052
Name:FOSTER, DANA (RPRS)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:
Credentials:RPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 PINE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23061-3229
Mailing Address - Country:US
Mailing Address - Phone:757-725-2306
Mailing Address - Fax:
Practice Address - Street 1:3327 PINE GROVE RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:VA
Practice Address - Zip Code:23061-3229
Practice Address - Country:US
Practice Address - Phone:757-725-2306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0735001253175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty