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Individual

SARAH GUSTAFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035
(423) 431-6562
Mailing address
400 N STATE OF FRANKLIN RD, JOHNSON CITY, TN 37604-6035

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0000048317
TN
207P00000X
Emergency Medicine Physician
2011-01268
NC

Other

Enumeration date
06/15/2009
Last updated
03/23/2017
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