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General NPI Number Information
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NPI Number | 1992800478
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Entity Type | Individual
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Provider Name | ROBERT LEE GUSTOFSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 80 HEALTH PARK DR STE 240
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City | LOUISVILLE
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State | CO
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Zip | 80027-4644
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Country | US
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Telephone | 303-665-0150
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Fax | 303-665-0740
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Provider Business Mailing Address
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Address Line | 10290 RIDGEGATE CIR
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City | LONE TREE
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State | CO
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Zip | 80124-5331
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Country | US
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Telephone | 303-788-8300
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Fax | 303-788-8310
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 44305
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License Number State | CO
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