Individual
SHASHIDHAR KUSUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8430 W BROWARD BLVD, SUITE 200, PLANTATION, FL 33324-2700
(954) 472-8355
(954) 472-8220
Mailing address
8430 W BROWARD BLVD, SUITE 200, PLANTATION, FL 33324-2700
(954) 472-8355
(954) 472-8220
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
107122
FL
208200000X
Plastic Surgery Physician
Primary
107122
FL
208200000X
Plastic Surgery Physician
35088257
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2670104
—
OH
Enumeration date
07/29/2006
Last updated
06/24/2010
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