Individual
DALE EDWARD GUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2118 25TH ST STE D, COLUMBUS, IN 47201-3240
(812) 372-8281
(812) 372-4525
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01038561A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000991448
ANTHEM PIN
IN
05
—
200003440
—
IN
Enumeration date
04/27/2006
Last updated
09/09/2024
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