Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 2006028223 | MO |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2006028223 | MO |
NPI | 1235104787 |
---|---|
Provider Name | Dr. Raymond Todd Foster SR. |
First Address | Columbia, MO 65205-7687 |
Second Address | Columbia, MO 65201-8104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 17/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I10597 | (02) | MO |