Provider Demographics
NPI:1083878409
Name:RICHARD J FOSTER D O P C
Entity type:Organization
Organization Name:RICHARD J FOSTER D O P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:D O
Authorized Official - Phone:734-429-5448
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-0066
Mailing Address - Country:US
Mailing Address - Phone:734-429-5448
Mailing Address - Fax:734-944-0900
Practice Address - Street 1:250 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1573
Practice Address - Country:US
Practice Address - Phone:734-429-5448
Practice Address - Fax:734-944-0900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRF006104305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1851359905OtherPERSONAL PHYSICIAN NPI
MI1851359905OtherPERSONAL PHYSICIAN NPI
MI5812659Medicare PIN