Individual
ERIC GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
1430 TULANE AVE, SL-16, NEW ORLEANS, LA 70112-2632
(504) 988-7518
Mailing address
1801 DAUPHINE ST, NEW ORLEANS, LA 70116-1926
(505) 688-1386
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A98818
CA
207R00000X
Internal Medicine Physician
MD.025860
LA
208M00000X
Hospitalist Physician
Primary
MD.025860
LA
208M00000X
Hospitalist Physician
MD2005-0487
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1046914
—
LA
Enumeration date
04/13/2007
Last updated
04/03/2017
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