Provider Demographics
NPI:1700447190
Name:FOSTER, JOSHUA WAYNE (DO)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:WAYNE
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:114 E SOUTH HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64468-2659
Mailing Address - Country:US
Mailing Address - Phone:660-562-4305
Mailing Address - Fax:660-562-4312
Practice Address - Street 1:114 E SOUTH HILLS DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:MO
Practice Address - Zip Code:64468-2659
Practice Address - Country:US
Practice Address - Phone:660-562-4305
Practice Address - Fax:660-562-4312
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20210266552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200071696Medicaid