Basic Information
| Provider Information | |||||||||
| NPI: | 1316130859 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOSTER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | G. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177454451 | ||||||||
| FaxNumber: | 3177186740 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | DANVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461221948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3177456139 | ||||||||
| FaxNumber: | 3177457873 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2007 | ||||||||
| LastUpdateDate: | 03/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 4301090702 | MI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 01067831A | IN | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200986750 | 05 | IN | MEDICAID | 000000668893 | 01 | ANTHEM BLUE SHIELD | OTHER |