# MR. JOSHUA J GUSTAFSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548491368
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | 001998 | IA | — |

## Other

- **Enumeration date:** 07/28/2009
- **Last updated:** 03/26/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | P00914933 | RR MEDICARE | IA |