Basic Information
| Provider Information | |||||||||
| NPI: | 1053504423 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SCHUSTER CARDIOLOGY ASSOCIATES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3533 SOUTHERN BLVD | ||||||||
| Address2: | SUITE 3550 | ||||||||
| City: | KETTERING | ||||||||
| State: | OH | ||||||||
| PostalCode: | 454291264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9376439939 | ||||||||
| FaxNumber: | 9376439939 | ||||||||
| Practice Location | |||||||||
| Address1: | 1141 N MONROE DR | ||||||||
| Address2: | |||||||||
| City: | XENIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 453851619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9373723638 | ||||||||
| FaxNumber: | 9373723642 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | TRACY | ||||||||
| AuthorizedOfficialFirstName: | KATY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9376439939 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 7868259 | 05 | OH | MEDICAID | CL4182 | 01 | OH | RAILROAD MEDICARE | OTHER |