Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 71005 | MA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 71005 | MA |
NPI | 1164490983 |
---|---|
Provider Name | Dr. Timothy Earle Foster |
First Address | Newton, MA 02462-1650 |
Second Address | Newton, MA 02462-1650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 01/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F21878 | (02) | MA |