Provider Demographics
NPI:1427237015
Name:DEUSER, DAVID SCOTT (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:DEUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 BENTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322
Mailing Address - Country:US
Mailing Address - Phone:917-828-7303
Mailing Address - Fax:
Practice Address - Street 1:700 COASTAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-1974
Practice Address - Country:US
Practice Address - Phone:912-554-8510
Practice Address - Fax:912-368-6844
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-31
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA651002084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY62M111Medicare UPIN