Gustafson, Robert

Gustafson, Robert is an individual health care provider with primary practice located at 1 Stadium Drive , Morgantown WV 26506. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Gustafson, Robert can be contacted via phone (304) 598-4800.

Contact Information

Primary practice address
1 Stadium Drive Morgantown WV 26506
Phone: (304) 598-4800
Fax: (304) 293-6963
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Surgery 2086S0120X 11159 West Virginia
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 11159 West Virginia

Profile Details

NPI number 1720185101
LBN Legal business name Gustafson, Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Apr 13th, 2022 - about 3 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 1720185101 NPPES
West Virginia Other 330004835 RAILROAD MEDICARE
West Virginia MEDICAID 0128544000 RAILROAD MEDICARE

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