Provider Demographics
NPI:1861711822
Name:SCHUSTER, JESSICA MOORE (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:MOORE
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5317 MARSH WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MC FARLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53558-9103
Mailing Address - Country:US
Mailing Address - Phone:770-634-5212
Mailing Address - Fax:
Practice Address - Street 1:250 DOCTORS CT
Practice Address - Street 2:
Practice Address - City:JOHNSON CREEK
Practice Address - State:WI
Practice Address - Zip Code:53038-9451
Practice Address - Country:US
Practice Address - Phone:920-699-3500
Practice Address - Fax:920-699-2100
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI643022085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology