Provider Demographics
NPI:1841203064
Name:SHEUSI, CARL JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:JAMES
Last Name:SHEUSI
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 1:811 7TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-6715
Mailing Address - Country:US
Mailing Address - Phone:239-263-7425
Mailing Address - Fax:239-263-3430
Practice Address - Street 1:811 7TH AVE S
Practice Address - Street 2:SENIOR FRIENDSHIP CENTERS
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-6715
Practice Address - Country:US
Practice Address - Phone:239-263-7425
Practice Address - Fax:239-263-3430
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLL415207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM008ZMedicare Oscar/Certification