Gustavel, Michael J
Gustavel, Michael J is an individual health care provider with primary practice located at 1702 W Fairview Ave , Boise ID 83702-5121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Gustavel, Michael J can be contacted via phone (208) 850-1641.Contact Information
Primary practice address
1702 W Fairview Ave
Boise ID 83702-5121
Phone: (208) 850-1641
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | M8510 | Idaho |
Profile Details
| NPI number | 1306842182 |
|---|---|
| LBN Legal business name | Gustavel, Michael J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2005 |
| Last updated | Feb 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 | 1306842182 | NPPES |
| Idaho | MEDICAID | 1306842182 |
Popular Providers
-
Miller, Jennifer Rawlings
1188 University Dr , Boise ID 83706 -
Wick, John M
703 S Americana Blvd Ste 120 , Boise ID 83702-6754 -
Jurgensmeier, Darin
6165 W Emerald Street , Boise ID 83704-8613 -
Walker, Robert N
703 S Americana Blvd Ste 120, Boise ID 83702-5099 -
Rolle, Garrison A
3334 Capital Medical Blvd Ste 400, Tallahassee FL 32308-8405 -
Heggland, Erik J
1109 W Myrtle St Suite 200, Boise ID 83702-6970 -
Beckmann, James Thomas
1109 W. Myrtle St. Suite 200 St. Luke'S Hospital System, Boise ID 83702 -
Wade, George A.
1188 University Dr , Boise ID 83706-3009