Provider Demographics
NPI:1043268139
Name:SCHUSTER, MARCUS OTTO (DC)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:OTTO
Last Name:SCHUSTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 PARK RD STE 117
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3669
Mailing Address - Country:US
Mailing Address - Phone:704-561-9494
Mailing Address - Fax:704-561-9595
Practice Address - Street 1:5200 PARK RD STE 117
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-3669
Practice Address - Country:US
Practice Address - Phone:704-561-9494
Practice Address - Fax:704-561-9595
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCU94452Medicare UPIN
NC2456676AMedicare ID - Type UnspecifiedPRIOVIDER ID