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Individual

DR. MARK A SHUST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OPTOMETRIST

Contact information

Practice address
121 KREWSON LN, CHELTENHAM, PA 19012-1202
(215) 379-1850
Mailing address
121 KREWSON LN, CHELTENHAM, PA 19012-1202
(215) 379-1850

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000935
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0470321000
KEYSTONE EAST
PA
01
1684739
BLUE SHIELD
PA
01
2248
AETNA HMO
PA
Enumeration date
08/12/2006
Last updated
06/18/2008
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