Individual
WILLIAM GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2916 42ND AVE S, MINNEAPOLIS, MN 55406-1820
(541) 602-1340
Mailing address
2916 42ND AVE S, MINNEAPOLIS, MN 55406-1820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/22/2014
Last updated
09/22/2014
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