Individual
DR. PAULA ANN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 W RAMPART ST, SHELBYVILLE, IN 46176-8897
(317) 398-7337
Mailing address
3625 WOODFIELD PL, COLUMBUS, IN 47203-1230
(812) 379-4382
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01044150A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200141250A
—
IN
Enumeration date
06/30/2006
Last updated
01/14/2014
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