MEDICARE: GARY S GUSTAFSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	4301046424	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	320F362430	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1093775199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY S GUSTAFSON MD

Provider Business Mailing Address
First Line	:	44378 DEQUINDRE RD
Second Line	:	STERLING HEIGHTS
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-1003
Country	:	US
Telephone Number	:	248-964-3070
Fax Number	:	248-964-0057

Provider Business Practice Location Address
First Line	:	44378 DEQUINDRE RD
Second Line	:	STERLING HEIGHTS
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48314-1003
Country	:	US
Telephone Number	:	248-964-3070
Fax Number	:	248-964-0057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	02/12/2015

Similar Medicare Providers

1043218621 — DR. SHARON K GEIMER MD
Practice Location Address:

44344 DEQUINDRE RD , SUITE 480
STERLING HEIGHTS, MI
48314-1003

Practice Phone: 586-323-8935
Practice Fax: 586-323-9058

1962478990 — DAVID RODGERS
Practice Location Address:

44300 DEQUINDRE RD , FAMILY MEDICINE CENTER
STERLING HEIGHTS, MI
48314-1003

Practice Phone: 248-964-0400
Practice Fax:

1710953724 — ANN FORDE
Practice Location Address:

44300 DEQUINDRE RD , FAMILY MEDICINE CENTER
STERLING HEIGHTS, MI
48314-1003

Practice Phone: 248-964-0400
Practice Fax:

1104962174 — PAUL EDWARD STEFFAN M.D.
Practice Location Address:

44300 DEQUINDRE RD
STERLING HEIGHTS, MI
48314-1003

Practice Phone: 248-964-0400
Practice Fax: 248-964-0401

1851425946 — MRS. CHRISTINA LOUISE WEISS A.T.,C.
Practice Location Address:

44300 DEQUINDRE RD
STERLING HEIGHTS, MI
48314-1003

Practice Phone: 248-964-0200
Practice Fax: 248-694-0220

1194849745 — MRS. SHARON DIANE COURTLEY P.T.
Practice Location Address:

44300 DEQUINDRE RD , EAST CAMPUS - PT
STERLING HEIGHTS, MI
48314-1003

Practice Phone: 248-964-0211
Practice Fax: 248-964-0220

Directions to “ GARY S GUSTAFSON MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.