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Individual

DR. WILLIAM G GUSTAFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1630 CHIPPEWA DR, RHINELANDER, WI 54501-9503
(715) 361-5480
(715) 361-5499
Mailing address
1630 CHIPPEWA DR, RHINELANDER, WI 54501-9503
(715) 361-5480
(715) 361-5499

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0031548
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31675600
WI
Enumeration date
04/25/2006
Last updated
12/17/2012
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