Provider Demographics
NPI:1912916644
Name:FOSTER, GERALD F (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:F
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT 9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4806
Mailing Address - Country:US
Mailing Address - Phone:617-421-2508
Mailing Address - Fax:617-421-3487
Practice Address - Street 1:147 MILK ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4806
Practice Address - Country:US
Practice Address - Phone:617-654-7240
Practice Address - Fax:617-654-7177
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-05-31
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Provider Licenses
StateLicense IDTaxonomies
MA49010207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00136859OtherMEDICARE RAILROAD
MA0014517OtherNEIGHBORHOOD HEALTH PLAN
MA3179559Medicaid
MA796019OtherTUFTS HEALTH PLAN
MAPD137OtherHARVARD PILGRIM
MA8585842-002OtherCIGNA
MAJ22450OtherBLUE CROSS
MA3179559Medicaid
MASX3450Medicare PIN