Provider Demographics
NPI:1770159824
Name:FOSTER, ONTERIA MAXINE
Entity type:Individual
Prefix:MS
First Name:ONTERIA
Middle Name:MAXINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 BELVEDERE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-5132
Mailing Address - Country:US
Mailing Address - Phone:706-593-1360
Mailing Address - Fax:
Practice Address - Street 1:730 BELVEDERE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-5132
Practice Address - Country:US
Practice Address - Phone:706-593-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty