Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 00012209 | AL |
NPI | 1093813230 |
---|---|
Provider Name | Dr. Kendal Irwin Foster |
First Address | Mobile, AL 36604-1402 |
Second Address | Mobile, AL 36604-1402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 09/07/2007 |