Provider Demographics
NPI:1174551832
Name:SCHUSTER, MICHAEL R (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:R
Last Name:SCHUSTER
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:PO BOX 4460
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-0460
Mailing Address - Country:US
Mailing Address - Phone:866-491-5807
Mailing Address - Fax:913-491-0411
Practice Address - Street 1:7500 MERCY RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124
Practice Address - Country:US
Practice Address - Phone:402-398-6198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE190142085R0202X
IA335142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2906701Medicaid
IA9906701Medicaid
NE06138OtherBCBS
IA0943290Medicaid
IA2906707Medicaid
IA5906701Medicaid
13044OtherMIDLANDS
IABS6851681OtherIA CONTROLLED SUBSTANCE
IA7906701Medicaid
IA8906701Medicaid
IA19827OtherBCBS
IA19827OtherBCBS
NE300033981Medicare PIN
IA19827Medicare PIN
IA2906701Medicaid
IA8906701Medicaid
IA0943290Medicaid
IA9906701Medicaid
BS1494715OtherDEA