Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | OP60635271 | WA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 5101019136 | MI |
NPI | 1699067751 |
---|---|
Provider Name | Dr. Michael Faherty Foster |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98122-5788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2011 |
Last Update Date | 02/08/2016 |