Provider Demographics
NPI:1528164522
Name:FOSTER, ANJANETTA LATRICE (MD)
Entity type:Individual
Prefix:DR
First Name:ANJANETTA
Middle Name:LATRICE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 LOMB AVE SW
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1416
Mailing Address - Country:US
Mailing Address - Phone:205-783-9877
Mailing Address - Fax:205-783-9866
Practice Address - Street 1:652 LOMB AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1416
Practice Address - Country:US
Practice Address - Phone:205-783-9877
Practice Address - Fax:205-783-9866
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18217207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF79982Medicare UPIN