Provider Demographics
NPI:1164468807
Name:SHUSTER, MATTHEW M (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:SHUSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:291 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3628
Mailing Address - Country:US
Mailing Address - Phone:617-541-6625
Mailing Address - Fax:617-541-7503
Practice Address - Street 1:291 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-3628
Practice Address - Country:US
Practice Address - Phone:617-541-6525
Practice Address - Fax:617-541-6444
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA58064207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ06602OtherBLUE CROSS
MA3173356Medicaid
MA058064OtherTUFTS
MAM550OtherHARVARD PILGRIM
MA0011255OtherNEIGHBORHOOD HEALTH
MA0011255OtherNEIGHBORHOOD HEALTH
MA058064OtherTUFTS