Healthcare Provider Details

I. General information

NPI: 1104821925
Provider Name (Legal Business Name): ADAM E. SCHUSSHEIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 02/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 POST RD
FAIRFIELD CT
06824-6016
US

IV. Provider business mailing address

1305 POST RD
FAIRFIELD CT
06824-6016
US

V. Phone/Fax

Practice location:
  • Phone: 203-292-2000
  • Fax: 203-292-0832
Mailing address:
  • Phone: 203-292-2000
  • Fax: 203-292-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number038738
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RH0005X
TaxonomyHypertension Specialist Physician
License Number038738
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number038738
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: