Provider Demographics
NPI:1588635007
Name:CUSTER, ROBERT M (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:CUSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:385 LIGHTHOUSE TRAIL
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458
Mailing Address - Country:US
Mailing Address - Phone:937-885-7826
Mailing Address - Fax:
Practice Address - Street 1:3180 KETTERING BLVD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45439-1924
Practice Address - Country:US
Practice Address - Phone:937-297-6072
Practice Address - Fax:937-293-0969
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35071776C207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology