| Dr Craig S Gustafson Llc | |
|
233 Ayer Rd Ste 10 Harvard MA 01451-1131 | |
| (978) 772-0698 | |
| Not Available |
| Full Name | Dr Craig S Gustafson Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 233 Ayer Rd, Harvard, Massachusetts |
| Authorized Official Name and Position | Craig Gustafson (OWNER) |
| Authorized Official Contact | 9787720698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Craig S Gustafson Llc 233 Ayer Rd Ste 10 Harvard MA 01451-1131 Ph: (978) 772-0698 | Dr Craig S Gustafson Llc 233 Ayer Rd Ste 10 Harvard MA 01451-1131 Ph: (978) 772-0698 |
| NPI Number | 1982737946 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 2163452665 |
|---|---|
| Medicare Enrollment ID | O20050815000731 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982737946 | NPI | - | NPPES |
| 9740091 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 153873 (Massachusetts) | Primary |
| Provider Name | Craig Gustafson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780660845 PECOS PAC ID: 9335030048 Enrollment ID: I20040323000355 |
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