Individual
COLETTE GUSHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
(269) 337-6400
Mailing address
1000 OAKLAND DR, KALAMAZOO, MI 49008-1282
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301055219
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3503903971
BCBS
—
05
—
4200171
—
MI
Enumeration date
03/14/2006
Last updated
05/24/2012
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