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Individual

KAREN SUE GUSTAFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
MD417830
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
D61910
MD
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD417830
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1022745620001
PA
05
405278100
MD
Enumeration date
05/05/2006
Last updated
10/28/2019
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