Provider Demographics
NPI:1770555310
Name:SCHUSTER, RICHARD G (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:SCHUSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6117 ALLISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4607
Mailing Address - Country:US
Mailing Address - Phone:317-434-1750
Mailing Address - Fax:317-434-1750
Practice Address - Street 1:6117 ALLISONVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4607
Practice Address - Country:US
Practice Address - Phone:317-434-1750
Practice Address - Fax:317-434-1750
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02004216A204D00000X, 207Q00000X
OH34006659S207Q00000X, 207QS0010X
IA3943207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
250013273OtherRAILROAD MEDICARE
2603120OtherAETNA
IA1770555310Medicaid
OH2276317Medicaid
2300625OtherUNITED HEALTHCARE
INP01424266OtherRAIL ROAD PTAN
IN201153770Medicaid
000000203487OtherANTHEM
IAP00718757OtherRR MEDICARE
04087OtherPARAMOUNT
IA415300006Medicare PIN
IN266180450Medicare PIN
H55309Medicare UPIN