Michael J Gustavel (NPI# 1306842182, PAC ID# 6901794148) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
Nation Provider ID (NPI) | 1306842182 |
PAC ID by PECOS | 6901794148 |
Professional Enrollment ID | I20190416001059 |
Full Name | Michael J Gustavel |
Address |
1702 W Fairview Ave Boise ID 83702-5121 |
Phone Number | 2089577400 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE |
Graduation Year | 1998 |
Primary Specialty | ORTHOPEDIC SURGERY |
Secondary Specialties | SPORTS MEDICINE |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
130063 | TREASURE VALLEY HOSPITAL |
130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
1702 W Fairview Ave, Boise, ID 83702-5121 | 2089577400 |
Street Address |
1702 W FAIRVIEW AVE |
City | BOISE |
State | ID |
Zip | 83702-5121 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kim Kutzner | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
Stacey L Scanlan | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
Jody Alison Thatcher Bullard | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
Ali Lubbers | Physical Therapy | Physical Therapy At Thrive, LLC | 2302 N Bogus Basin Rd, Suite C, Boise, ID 83702-1024 |
David A Teed | Clinical Social Worker | 1407 N 13th St, Boise, ID 83702-3531 | |
Martha Ann Stacy | Psychologist, Clinical | 1718 W Jefferson St, Boise, ID 83702-3949 | |
Renee Ours Bild | Clinical Social Worker | 1718 W Jefferson St, Boise, ID 83702-3949 | |
Amber L Simonson | Optometry | Ada Vision Center Pa | 1926 W State St, Boise, ID 83702-3957 |
Todd Anthony Noble | Optometry | Ada Vision Center Pa | 1926 W State St, Boise, ID 83702-3957 |
Lauren M Huber | Optometry | Ada Vision Center Pa | 1926 W State St, Boise, ID 83702-3957 |
Find all physicians in zip 83702 |
City | BOISE |
Zip Code | 83702 |
Specialty | ORTHOPEDIC SURGERY |
City + Specialty | BOISE + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Michael J Gustavel.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.