Provider Demographics
NPI:1558398438
Name:FUERSTMAN, LOUIS PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:PETER
Last Name:FUERSTMAN
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 1:2680 MILLWOOD CT
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2430
Mailing Address - Country:US
Mailing Address - Phone:770-621-9619
Mailing Address - Fax:
Practice Address - Street 1:196 RIDGECREST CIR
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4111
Practice Address - Country:US
Practice Address - Phone:706-782-4233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA024939207P00000X
GA24939208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD29508Medicare UPIN