MEDICARE: DR. ROBERT WILLIAM CUSHNER DPM

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	213E00000X	Podiatrist	000476	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568480051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT WILLIAM CUSHNER DPM

Provider Business Mailing Address
First Line	:	PO BOX 1106
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30459-1106
Country	:	US
Telephone Number	:	912-489-8727
Fax Number	:	912-764-7882

Provider Business Practice Location Address
First Line	:	95 BEL AIR DRIVE
Second Line	:
City	:	STATESBORO
State	:	GA
Zip	:	30461
Country	:	US
Telephone Number	:	912-489-8727
Fax Number	:	912-764-7882

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	02/20/2013

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