GARY S GUSTAFSON MD NPI 1093775199

NPI Information

  • NPI: 1093775199
  • Provider Name: GARY S GUSTAFSON, MD
  • Classification: Radiology - 2085R0001X
  • Specialization: Radiation Oncology
  • Entity Type: Individual
  • Address: 44378 DEQUINDRE RD
    STERLING HEIGHTS
    STERLING HEIGHTS, MI
    ZIP 48314
  • Phone: (248) 964-3070

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NPI Details

Gary S Gustafson, MD is a radiation oncology radiology in Sterling Heights, MI. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. Gary S Gustafson, MD NPI is 1093775199. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

44378 DEQUINDRE RD
STERLING HEIGHTS
STERLING HEIGHTS, MI
ZIP 48314-003
Phone: (248) 964-3070
Fax: (248) 964-0057

The enumeration date for this NPI number is 3/24/2006 and was last updated on 2/12/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0001XRadiologyRadiation Oncology4301046424MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1320F362430OTHERMICHIGANBCBSM
20F36076009MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
32588472MEDICAIDMICHIGAN
4A94290MEDICARE UPINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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