Individual
DR. MARK D. GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 10TH AVE NE, DEER RIVER, MN 56636-8795
(218) 246-8275
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-4222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34203
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
430703800
—
MN
Enumeration date
12/26/2005
Last updated
12/21/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us