Provider Demographics
NPI:1215963723
Name:FOSTER-GALBRAITH, PAULETTE L (MD)
Entity type:Individual
Prefix:DR
First Name:PAULETTE
Middle Name:L
Last Name:FOSTER-GALBRAITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PAULETTE
Other - Middle Name:
Other - Last Name:GALBRAITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:130 DARRAN ST
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3409
Mailing Address - Country:US
Mailing Address - Phone:228-831-1988
Mailing Address - Fax:228-832-3844
Practice Address - Street 1:130 DARRAN ST
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3409
Practice Address - Country:US
Practice Address - Phone:228-831-1988
Practice Address - Fax:228-832-3844
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14436207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0115339Medicaid
MS$$$$$$$$$FOtherBCBS
MS0115339Medicaid
MS080072574Medicare PIN
MS$$$$$$$$$FOtherBCBS
MS0115339Medicaid