Provider Demographics
NPI:1457494445
Name:SCHUSSER, ELIZABETH WRIGHT (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:WRIGHT
Last Name:SCHUSSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28 PUAPAKE PL APT 1
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-3209
Mailing Address - Country:US
Mailing Address - Phone:808-662-5642
Mailing Address - Fax:808-662-5642
Practice Address - Street 1:180 DICKENSON ST STE 103
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1215
Practice Address - Country:US
Practice Address - Phone:808-662-5642
Practice Address - Fax:808-662-5642
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6743207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIC063705OtherHMSA
HI191746I1OtherPIN
HI260031934OtherTAX ID
HI52799701Medicaid
HIC87983Medicare UPIN
HI191746I1OtherPIN