Gustafson, Kevin

Gustafson, Kevin is an individual health care provider with primary practice located at 250 Thompson St , Saint Paul MN 55102-2370. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Gustafson, Kevin can be contacted via phone (651) 292-2000.

Contact Information

Primary practice address
250 Thompson St Saint Paul MN 55102-2370
Phone: (651) 292-2000
Fax: (651) 292-2136
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 26344 Minnesota

Profile Details

NPI number 1891745865
LBN Legal business name Gustafson, Kevin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 11th, 2006
Last updated Apr 25th, 2019 - about 5 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 1891745865 NPPES
Minnesota MEDICAID 425272100

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