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General NPI Number Information
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NPI Number | 1861660573
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Entity Type | Organization
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Legal Business Name | JEFFREY M SHUSTER MD PC
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 42633 GARFIELD RD SUITE 319
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City | CLINTON TWP
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State | MI
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Zip | 48038-5033
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Country | US
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Telephone | 586-263-0777
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Fax | 586-263-5457
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Provider Business Mailing Address
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Address Line | 42633 GARFIELD RD SUITE 319
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City | CLINTON TWP
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State | MI
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Zip | 48038-5033
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Country | US
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Telephone | 586-263-0777
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Fax | 586-263-5457
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. JEFFREY M SHUSTER
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Credential | MD
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Telephone | 586-263-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | JS053096
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License Number State | MI
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