Individual
DR. CHAD AMBROSE GUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 MAINE ST, LAWRENCE, KS 66044-1360
(785) 505-5000
Mailing address
325 MAINE ST, LAWRENCE, KS 66044-1360
(785) 505-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32991
KS
207P00000X
Emergency Medicine Physician
M5739
TX
Other
Enumeration date
06/10/2008
Last updated
03/19/2014
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