Individual
DR. THEODORE SHUSTER PABST III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
24 HAMMOND LN, PLATTSBURGH, NY 12901-2076
(518) 562-7557
(518) 562-7559
Mailing address
24 HAMMOND LN, PLATTSBURGH, NY 12901-2006
(518) 562-7557
(518) 562-7559
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
187640
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01276613
—
NY
01
—
020014148
RR MCARE INDIV
NY
01
—
CM1443
RR MEDICARE GROUP
NY
Enumeration date
09/25/2006
Last updated
02/23/2023
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