Gustilo, Rose Marie

Gustilo, Rose Marie is an individual health care provider with primary practice located at 2518 Darda St , Henderson NV 89044-1588. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Gustilo, Rose Marie can be contacted via phone (702) 617-3597.

Contact Information

Primary practice address
2518 Darda St Henderson NV 89044-1588
Phone: (702) 617-3597
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD035835E Pennsylvania
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 0101050885 Virginia
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X D23777 Maryland

Profile Details

NPI number 1023199429
LBN Legal business name Gustilo, Rose Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jul 20th, 2011 - about 15 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 1023199429 NPPES
Arizona MEDICAID 136841

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