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NPI Code Detail

MEDICARE: TODD RUSSELL ZUSMER D.O.

MEDICARE: TODD RUSSELL ZUSMER D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOS7932FL
2207Q00000XFamily Medicine Physician1377SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00892907OTHERSCRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801884887
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD RUSSELL ZUSMER D.O.
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 SCUFFLETOWN RD
Second Line :
City : SIMPSONVILLE
State : SC
Zip : 29681-7204
Country : US
Telephone Number : 864-329-0029
Fax Number : 864-329-8125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 02/17/2023

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