| Doctor Name: | RICHARD FOREMAN |
| NPI Number: | 1033586680 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | COA18027NP |
| Business Practice Address: | 3535 Southern Blvd Kettering, OH - 454291221 |
| Business Phone Number: | 9373956665 |
| Business Fax Number: | 9375229260 |
| Mailing Address: | 3535 Southern Blvd, KETTERING |
| State: | OH |
| Postal Code: | 454291221 |
| Phone Number: | 9373956665 |
| Fax Number: | 9375229260 |
| NPI Enumeration Date: | 08/31/2015 |
| NPI Last Update Date: | 10/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | COA18027NP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |