Individual
DR. LARRY SHUSTERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 S 28TH ST, PHILADELPHIA, PA 19145-1202
(215) 334-1166
(215) 336-1776
Mailing address
1600 S 28TH ST, PHILADELPHIA, PA 19145-1202
(215) 334-1166
(215) 336-1776
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS-006113-L
PA
207R00000X
Internal Medicine Physician
Primary
OS-006113-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011417470005
—
PA
01
—
0080977002
KEYSTONE HEALTH PLAN EAST
PA
01
—
0114174702
AMERICHOICE
PA
01
—
100326
KEYSTONE MERCY HEALTH PLA
PA
01
—
110127288
PALMETTO GBA
PA
01
—
4348882
AETNA
PA
01
—
6724
ELDERHEALTH
PA
01
—
98583
US HEALTHCARE
PA
Enumeration date
09/06/2006
Last updated
03/23/2016
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