| Doctor Name: | DR. STEVEN THOMAS FOSMIRE |
| NPI Number: | 1558653063 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 1200 |
| Business Practice Address: | Raf Lakenheath 48 Mdg/sghc Unit 5115 Apo, AE - 094615115 |
| Business Phone Number: | 011441638528124 |
| Business Fax Number: | |
| Mailing Address: | Raf Lakenheath 48 Mdg/sghc, Unit 5115 APO |
| State: | AE |
| Postal Code: | 094615115 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2011 |
| NPI Last Update Date: | 08/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1200 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |