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General NPI Number Information
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NPI Number | 1952348732
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Entity Type | Organization
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Legal Business Name | DAVID B SHUSTER
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2600 FAR HILLS AVE STE 309
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City | KETTERING
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State | OH
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Zip | 45419-1602
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Country | US
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Telephone | 937-266-4668
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Fax | 866-839-8449
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Provider Business Mailing Address
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Address Line | 2600 FAR HILLS AVE STE 309
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City | KETTERING
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State | OH
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Zip | 45419-1602
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Country | US
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Telephone | 937-266-4668
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Fax | 866-839-8449
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Authorized Official
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Title or Position | OWNER
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Name | DAVID BRYAN SHUSTER
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Credential | M.D.
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Telephone | 937-643-1071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0004X
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Taxonomy Name | Spinal Cord Injury Medicine Physician
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License Number |
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License Number State |
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