Individual
JOHN G GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1722 SHAFFER ST, SUITE 1, KALAMAZOO, MI 49048-1633
(269) 381-3963
(269) 381-2809
Mailing address
1722 SHAFFER ST, SUITE 1, KALAMAZOO, MI 49048-1633
(269) 381-3963
(269) 381-2809
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
4301069176
MI
207RI0011X
Interventional Cardiology Physician
Primary
4301069176
MI
Other
Enumeration date
02/07/2006
Last updated
07/16/2015
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