Kusuma, Shashidhar

Kusuma, Shashidhar is an individual health care provider with primary practice located at 8430 W Broward Blvd Suite 200, Plantation FL 33324-2700. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Kusuma, Shashidhar can be contacted via phone (954) 472-8355.

Contact Information

Primary practice address
8430 W Broward Blvd Suite 200 Plantation FL 33324-2700
Phone: (954) 472-8355
Fax: (954) 472-8220
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 35088257 Ohio
Allopathic & Osteopathic Physicians / Plastic Surgery within the Head & Neck 207YX0007X 107122 Florida
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 107122 Florida

Profile Details

NPI number 1598770430
LBN Legal business name Kusuma, Shashidhar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2006
Last updated Jun 24th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598770430 NPPES
Ohio MEDICAID 2670104

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