Gustafson, Robert
Gustafson, Robert is an individual health care provider with primary practice located at 1 Stadium Drive , Morgantown WV 26506. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Surgery, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is his primary health care specialty. Gustafson, Robert can be contacted via phone (304) 598-4800.Contact Information
Primary practice address
1 Stadium Drive
Morgantown WV 26506
Phone: (304) 598-4800
Fax: (304) 293-6963
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Surgery | 2086S0120X | 11159 | West Virginia |
| Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) | 208G00000X | 11159 | West Virginia |
Profile Details
| NPI number | 1720185101 |
|---|---|
| LBN Legal business name | Gustafson, Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Apr 13th, 2022 - about 4 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 | 1720185101 | NPPES |
| West Virginia | Other | 330004835 | RAILROAD MEDICARE |
| West Virginia | MEDICAID | 0128544000 | RAILROAD MEDICARE |
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