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Contact Information

GAY L GUSTAFSON, DPM
7700 MENAUL BLVD NE
STE D
ALBUQUERQUE, NM87110-4616
 Phone: 505-299-4487
 Fax: 505-299-4498
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for GAY L GUSTAFSON · (Female)

NPI Number 1003980178
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 11/20/2006
Last updated 07/10/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • NM License # 252
  • NM Medicaid Q4698
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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