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Contact Information

ALICIA GUSTAFSON, DO
8100 NORTHLAND DR
BLOOMINGTON, MN55431-4800
 Phone: 952-831-8742
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Family Medicine - Sports Medicine

207QS0010X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for ALICIA GUSTAFSON · (Female)

NPI Number 1417210790
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 06/21/2012
Last updated 05/10/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 75542
  • TX License # S9140
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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