Provider Demographics
NPI:1669426961
Name:FOSTER-WEISS, KARA L (M,D)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:L
Last Name:FOSTER-WEISS
Suffix:
Gender:F
Credentials:M,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 WADSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4510
Mailing Address - Country:US
Mailing Address - Phone:804-228-3627
Mailing Address - Fax:804-560-1312
Practice Address - Street 1:229 WADSWORTH DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-4510
Practice Address - Country:US
Practice Address - Phone:804-228-3627
Practice Address - Fax:804-560-1312
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017000577363LF0000X
VA0101255880207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006706V26Medicare PIN
VAP00222839Medicare PIN
VAVVA507BMedicare PIN
VAS04403Medicare UPIN
VA016087V27Medicare PIN
VA016732V28Medicare PIN