Provider Demographics
NPI:1245220904
Name:SHUSTER, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:SHUSTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 6TH AVE N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2735
Mailing Address - Country:US
Mailing Address - Phone:320-252-5131
Mailing Address - Fax:320-240-2118
Practice Address - Street 1:1200 6TH AVE N
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2735
Practice Address - Country:US
Practice Address - Phone:320-252-5131
Practice Address - Fax:320-240-2118
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN27028207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
2114133OtherFIRST HEALTH PLAN
27028OtherMN LICENSE #
596784OtherARAZ GROUP/AMERICAS PPO
356501OtherPREFERRED ONE
HP22742OtherHEALTH PARTNERS
110919OtherU-CARE
6D090SHOtherBLUE CROSS BLUE SHIELD
0426446OtherMEDICA HEALTH PLANS
0426446OtherMEDICA HEALTH PLANS
356501OtherPREFERRED ONE