Healthcare Provider Details

I. General information

NPI: 1083857221
Provider Name (Legal Business Name): ADAM SCHUESSLER D.M.D. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2009
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1772 ST LUCIE W. BLVD
PORT SAINT LUCIE FL
34986
US

IV. Provider business mailing address

87 COUNTY ROAD 520
MORGANVILLE NJ
07751-1241
US

V. Phone/Fax

Practice location:
  • Phone: 772-337-8600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN25577
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: