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NPI Code Detail

MEDICARE: DR. ADAM MICHAEL SHUSTER DO

MEDICARE: DR. ADAM MICHAEL SHUSTER DO
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
1207L00000XAnesthesiology Physician5101015925MI
2207LP2900XPain Medicine (Anesthesiology) PhysicianOS10812FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1146VAOTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1417167784
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADAM MICHAEL SHUSTER DO
Provider Business Mailing Address
First Line : 23 BARKLEY CIR
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-7531
Country : US
Telephone Number : 239-333-1177
Fax Number : 239-333-1169
Provider Business Practice Location Address
First Line : 7964 SUMMERLIN LAKES DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33907-1816
Country : US
Telephone Number : 239-333-1177
Fax Number : 239-333-1169
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 01/28/2022

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