Healthcare Provider Details

I. General information

NPI: 1023233400
Provider Name (Legal Business Name): ERIC GUSTAFSON M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 TULANE AVE SL-16
NEW ORLEANS LA
70112-2632
US

IV. Provider business mailing address

1801 DAUPHINE ST
NEW ORLEANS LA
70116-1926
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-7518
  • Fax:
Mailing address:
  • Phone: 505-688-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD2005-0487
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.025860
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA98818
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD.025860
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: