Provider Demographics
NPI:1548252018
Name:FOUST, PAULA M (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:M
Last Name:FOUST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N SWALLOWTAIL DR
Mailing Address - Street 2:ST. 102B
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-6102
Mailing Address - Country:US
Mailing Address - Phone:386-492-6929
Mailing Address - Fax:386-492-6930
Practice Address - Street 1:900 N SWALLOWTAIL DR
Practice Address - Street 2:ST. 102B
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-6102
Practice Address - Country:US
Practice Address - Phone:386-492-6929
Practice Address - Fax:386-492-6930
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97528207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL207V00000XOtherTAXONOMY CODE
FL277730400Medicaid
FLAE756ZMedicare PIN