Healthcare Provider Details

I. General information

NPI: 1063856375
Provider Name (Legal Business Name): THOMAS R SCHUSTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2013
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 3RD AVE SE
ABERDEEN SD
57401-5420
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 605-626-4200
  • Fax: 605-626-4211
Mailing address:
  • Phone: 605-328-6585
  • Fax: 605-328-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCR000822
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: