Individual
DR. DAVID KEVIN GUSTAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
900 COOPER AVE, SUITE 4400, SAGINAW, MI 48602-5182
(989) 583-4401
(989) 583-4409
Mailing address
1447 N HARRISON ST, SAGINAW, MI 48602-4727
(989) 583-4401
(989) 583-4409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101010467
MI
2083X0100X
Occupational Medicine Physician
5101010467
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3508260
—
MI
Enumeration date
02/21/2006
Last updated
09/03/2014
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