Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | 2004018042 | MO |
Y | 2080P0202X | Pediatric Cardiologist | 55104 | WI |
NPI | 1215953450 |
---|---|
Provider Name | Dr. Susan R Foerster |
First Address | Milwaukee, WI 53226-4874 |
Second Address | Milwaukee, WI 53226-4874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 20/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1215953450 | (05) | WI |
209115104 | (05) | MO |
I42193 | (02) |