MEDICARE: JONATHAN SCHUSTER

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
1	152W00000X	Optometrist	2605	SC

General Provider Information

NPI Number	:	1104759786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN SCHUSTER

Provider Business Mailing Address
First Line	:	612 SAINT ANDREWS RD STE 12
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-5120
Country	:	US
Telephone Number	:	803-766-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	612 SAINT ANDREWS RD STE 12
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29210-5120
Country	:	US
Telephone Number	:	803-766-2020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ JONATHAN SCHUSTER ” Practice Location

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