Gustafson, Nicholas

Gustafson, Nicholas is an individual health care provider with primary practice located at 1222 N 23Rd St , Sheboygan WI 53081-3171. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is his primary health care specialty. Gustafson, Nicholas can be contacted via phone (920) 457-6800.

Contact Information

Primary practice address
1222 N 23Rd St Sheboygan WI 53081-3171
Phone: (920) 457-6800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 02005360A Indiana
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 72979 Wisconsin

Profile Details

NPI number 1508286386
LBN Legal business name Gustafson, Nicholas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2014
Last updated Dec 11th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508286386 NPPES
Wisconsin MEDICAID 100139705

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