Gary S Gustafson, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

4301046424 Issued in MI

Practice address

44378 Dequindre Rd
Sterling Heights
Sterling Heights, MI 48314-1003

Phone

(248) 964-3070

Fax

(248) 964-0057

NPI assigned

Mar 24, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Radiation Oncology Services, P.L.C.

  • Radiation Oncology Physician
  • Royal Oak, MI
  • NPI 1477654028
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1093775199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44378 DEQUINDRE RD",
            "address_2": "STERLING HEIGHTS",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141003",
            "telephone_number": "248-964-3070",
            "fax_number": "248-964-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44378 DEQUINDRE RD",
            "address_2": "STERLING HEIGHTS",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141003",
            "telephone_number": "248-964-3070",
            "fax_number": "248-964-0057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUSTAFSON",
        "first_name": "GARY",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301046424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2588472",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "320F362430",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amita Gupta, M.D.
• Paramvir Singh J Guram
• Gurbir Singh MD PLLC
• Ethan Gurin
• Rachel Helen Gurka, LMSW
• Autumn Gutierrez
• Alyssa Guyett
• Matthew Guyor
• H&M Services LLC
• Cristina Haass, MPT

• Radiation Oncology Physician in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Radiation Oncology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.