Provider Demographics
NPI:1245201607
Name:SCHUSTER, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:SCHUSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2048
Mailing Address - Country:US
Mailing Address - Phone:517-205-2700
Mailing Address - Fax:517-205-2700
Practice Address - Street 1:760 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2048
Practice Address - Country:US
Practice Address - Phone:517-205-2700
Practice Address - Fax:517-205-2720
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301046075208000000X
MIJS04060752080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1245201607Medicaid
MI12-00399OtherPHP
MI350190010OtherBCBS
MIP26198FOtherBCN
MI4565932Medicaid
IL279500OtherMEDICARE GROUP
ILK45745Medicare PIN
IL0407950001Medicare NSC
MIE90143Medicare UPIN
MI350190010OtherBCBS