Mark Edward Gustafson in Wooster - General Practice
Mark Edward Gustafson - NPI 1114033214
Mark Edward Gustafson is a General Practice in Wooster, Ohio. Mark Edward Gustafson practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mark Edward Gustafson is 1114033214. The last update date is 2009-09-04.
Mark Edward Gustafson's current location address is 3431 Commerce Parkway, Wooster, Ohio. You can contact this provider via phone number 3302648973 and fax number 3302623072. The mailing address for Mark Edward Gustafson is 3431 Commerce Parkway, Wooster, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Edward Gustafson |
|---|---|
| Address | 3431 Commerce Parkway, Wooster, Ohio |
| Phone Number | 3302648973 |
| Fax Number | 3302623072 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1114033214 |
|---|---|
| Provider Enumeration Date | 2006-08-22 |
| Last Updated Date | 2009-09-04 |
Provider Mailing Address Detail
| Address | 3431 Commerce Parkway |
|---|---|
| City | Wooster |
| State | Ohio (OH) |
| Post Code | 44691 |
| Phone Number | 3302648973 |
| Fax Number | 3302623072 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 30-017218 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 518836 | OH | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Mark Edward Gustafson by the Centers for Medicare & Medicaid Services?
The Mark Edward Gustafson has been assigned the NPI (National Provider Identifier) 1114033214 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the Mark Edward Gustafson's physical address?
The Mark Edward Gustafson is physically located at 3431 Commerce Parkway, in the city of Wooster, OH, with the postal code 44691.
What is Mark Edward Gustafson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mark Edward Gustafson is General Practice, and the taxonomy classification code that categorizes this area of expertise is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services issue the 1114033214 to Mark Edward Gustafson?
The Mark Edward Gustafson received its 1114033214 assignment from the Centers for Medicare & Medicaid Services on 2006-08-22.
When was the information pertaining to Mark Edward Gustafson most recently updated or revised?
The details related to Mark Edward Gustafson, including its address, specialty, and other relevant information, were last updated or revised on 2009-09-04.