Healthcare Provider Details

I. General information

NPI: 1952348732
Provider Name (Legal Business Name): DAVID B SHUSTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 FAR HILLS AVE STE 309
KETTERING OH
45419-1602
US

IV. Provider business mailing address

2600 FAR HILLS AVE STE 309
KETTERING OH
45419-1602
US

V. Phone/Fax

Practice location:
  • Phone: 937-266-4668
  • Fax: 866-839-8449
Mailing address:
  • Phone: 937-266-4668
  • Fax: 866-839-8449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID BRYAN SHUSTER
Title or Position: OWNER
Credential: M.D.
Phone: 937-643-1071