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General NPI Number Information
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NPI Number | 1033109459
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Entity Type | Organization
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Legal Business Name | JERI SHUSTER, M.D., PA
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11065 LITTLE PATUXENT PKWY SUITE 200
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City | COLUMBIA
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State | MD
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Zip | 21044-2998
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Country | US
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Telephone | 410-730-5700
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Fax | 410-964-3231
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Provider Business Mailing Address
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Address Line | 11065 LITTLE PATUXENT PKWY SUITE 200
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City | COLUMBIA
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State | MD
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Zip | 21044-2998
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Country | US
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Telephone | 410-730-5700
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Fax | 410-964-3231
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. JERI SHUSTER
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Credential | M.D.
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Telephone | 410-730-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | D34215
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License Number State | MD
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