Gustafson, Karen Sue
Gustafson, Karen Sue is an individual health care provider with primary practice located at 800 Spruce St , Philadelphia PA 19107-6130. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology is her primary health care specialty. Gustafson, Karen Sue can be contacted via phone (215) 829-3000.Contact Information
Primary practice address
800 Spruce St
Philadelphia PA 19107-6130
Phone: (215) 829-3000
Fax: (215) 829-7564
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD417830 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | D61910 | Maryland |
| Allopathic & Osteopathic Physicians / Anatomic Pathology | 207ZP0101X | MD417830 | Pennsylvania |
Profile Details
| NPI number | 1417905076 |
|---|---|
| LBN Legal business name | Gustafson, Karen Sue |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Oct 28th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417905076 | NPPES |
| Pennsylvania | MEDICAID | 1022745620001 | |
| Pennsylvania | MEDICAID | 405278100 |
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