MEDICARE: DAVID B SHUSTER

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
1	2081P0004X	Spinal Cord Injury Medicine Physician

General Provider Information

NPI Number	:	1952348732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID B SHUSTER

Provider Business Mailing Address
First Line	:	2600 FAR HILLS AVE
Second Line	:	STE 309
City	:	KETTERING
State	:	OH
Zip	:	45419-1602
Country	:	US
Telephone Number	:	937-266-4668
Fax Number	:	866-839-8449

Provider Business Practice Location Address
First Line	:	2600 FAR HILLS AVE
Second Line	:	STE 309
City	:	KETTERING
State	:	OH
Zip	:	45419-1602
Country	:	US
Telephone Number	:	937-266-4668
Fax Number	:	866-839-8449

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID BRYAN SHUSTER
Credential	:	M.D.
Telephone Number	:	937-643-1071

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/22/2020

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Directions to “DAVID B SHUSTER ” Practice Location

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