Healthcare Provider Details
I. General information
NPI: 1336190156
Provider Name (Legal Business Name): DEBRA K. SCHUSTER M.D. F.A.C.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/15/2006
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3301 CRANBERRY BLVD
WESTON WI
54476-5216
US
IV. Provider business mailing address
1014 COUNTRY CLUB RD
SCHOFIELD WI
54476-1827
US
V. Phone/Fax
- Phone: 715-393-2513
- Fax: 715-393-2655
- Phone: 715-298-0998
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 26762-020 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: