Provider Demographics
NPI:1821080649
Name:SCHUSTER, JENNIFER A (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219
Mailing Address - Country:US
Mailing Address - Phone:513-585-2236
Mailing Address - Fax:
Practice Address - Street 1:2139 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-585-2236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35082084207P00000X
NC2006-00812207P00000X
SC31537207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC193993OtherMEDCOST
SC315377Medicaid
NC143KGOtherBCBS OF NC
OH2388107Medicaid
NCP00374475OtherRAILROAD MEDICARE
OH000000356098OtherANTHEM
NC5905287Medicaid
NC193993OtherMEDCOST
OH000000356098OtherANTHEM
NC2059053Medicare PIN
OHSC7327811Medicare ID - Type Unspecified
SCAA36908510Medicare PIN
P00146737Medicare ID - Type UnspecifiedRAILROAD