Gustafson, William G

Gustafson, William G is an individual health care provider with primary practice located at 1630 Chippewa Dr , Rhinelander WI 54501-9503. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gustafson, William G can be contacted via phone (715) 361-5480.

Contact Information

Primary practice address
1630 Chippewa Dr Rhinelander WI 54501-9503
Phone: (715) 361-5480
Fax: (715) 361-5499
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0031548 Wisconsin

Profile Details

NPI number 1780640094
LBN Legal business name Gustafson, William G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Dec 17th, 2012 - about 12 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 1780640094 NPPES
Wisconsin MEDICAID 31675600

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