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NPI Code Detail

MEDICARE: MR. TODD PHILIP SCHUSTER P.A.

MEDICARE: MR. TODD PHILIP SCHUSTER P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician12672975-1206UT

General Provider Information

NPI Number : 1063762839
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TODD PHILIP SCHUSTER P.A.
Provider Business Mailing Address
First Line : 174 N H ST
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84103-2991
Country : US
Telephone Number : 602-828-1989
Fax Number :
Provider Business Practice Location Address
First Line : 660 S 200 E STE 250
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84111-3846
Country : US
Telephone Number : 801-359-2256
Fax Number : 801-364-4392
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2012
Last Update Date : 01/30/2024

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