Provider Demographics
NPI:1568443125
Name:FOSTER, STANLEY J III (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:J
Last Name:FOSTER
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1625 STRAITS TURNPIKE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762
Mailing Address - Country:US
Mailing Address - Phone:203-577-6550
Mailing Address - Fax:203-577-6551
Practice Address - Street 1:1625 STRAITS TURNPIKE
Practice Address - Street 2:SUITE 108
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762
Practice Address - Country:US
Practice Address - Phone:203-577-6550
Practice Address - Fax:203-577-6551
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2017-10-13
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Provider Licenses
StateLicense IDTaxonomies
CT0344572082S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT034457OtherSTATE LICENSE
240000129Medicare ID - Type Unspecified
CT034457OtherSTATE LICENSE