Gaustad, David G
Gaustad, David G is an individual health care provider with primary practice located at 615 S Mill St Suite 2, Fergus Falls MN 56537-2756. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Gaustad, David G can be contacted via phone (218) 998-2020.Contact Information
Primary practice address
615 S Mill St Suite 2
Fergus Falls MN 56537-2756
Phone: (218) 998-2020
Fax: (218) 998-2098
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | 025206 | Minnesota |
Profile Details
| NPI number | 1720316409 |
|---|---|
| LBN Legal business name | Gaustad, David G |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 18th, 2009 |
| Last updated | Nov 18th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720316409 | NPPES |
| Minnesota | Other | 4C853GA | BLUE CROSS BLUE SHIELD OF MN |
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