Provider Demographics
NPI:1316052699
Name:FOSTER, WAYNE PAUL (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:PAUL
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LAKEHURST RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8021
Mailing Address - Country:US
Mailing Address - Phone:732-914-1461
Mailing Address - Fax:
Practice Address - Street 1:500 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8021
Practice Address - Country:US
Practice Address - Phone:732-914-1461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06338100207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF81130Medicare UPIN
NJJ38250OtherHEALTHNET
NJ060045Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NJ0003031QT4Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL
NJF81130Medicare UPIN