Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 4301046075 | MI |
NPI | 1245201607 |
---|---|
Provider Name | Dr. John S Schuster |
First Address | Jackson, MI 49201-2048 |
Second Address | Jackson, MI 49201-2048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12-00399 | PHP (01) | MI |
1245201607 | (05) | IL |
279500 | MEDICARE GROUP (01) | IL |
350190010 | BCBS (01) | MI |
4565932 | (05) | MI |
E90143 | (02) | MI |
P26198F | BCN (01) | MI |