Basic Information
| Provider Information | |||||||||
| NPI: | 1104821925 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHUSSHEIM | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1305 POST RD | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068246016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032922000 | ||||||||
| FaxNumber: | 2032920832 | ||||||||
| Practice Location | |||||||||
| Address1: | 1305 POST RD | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068246016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032922000 | ||||||||
| FaxNumber: | 2032920832 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2005 | ||||||||
| LastUpdateDate: | 02/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 038738 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RH0005X | 038738 | CT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hypertension Specialist | 207UN0901X | 038738 | CT | Y | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 001387382 | 05 | CT | MEDICAID |