Individual
DR. LARRY VON KUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
715 S TAFT AVE, FREMONT, OH 43420-3200
(419) 332-7321
(419) 334-6693
Mailing address
715 S TAFT AVE, FREMONT, OH 43420-3200
(419) 332-7321
(419) 334-6693
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35047303
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0529128
—
OH
01
—
220016456
RAILROAD MEDICARE
—
Enumeration date
05/25/2006
Last updated
04/22/2008
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