Kevin D Gustafson (NPI# 1891745865, PAC ID# 5193620839) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1891745865 |
| PAC ID by PECOS | 5193620839 |
| Professional Enrollment ID | I20100525000696 |
| Full Name | Kevin D Gustafson |
| Organization Legal Name | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| Address |
5200 Fairview Blvd Wyoming MN 55092-8013 |
| Phone Number | 6519827000 |
| Gender | M |
| Medical School | UNIVERSITY OF IOWA COLLEGE OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 2466357272 |
| Number of Group Practice Members | 75 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 240078 | FAIRVIEW SOUTHDALE HOSPITAL |
| 240050 | FAIRVIEW LAKES HEALTH SERVICES |
| 240207 | FAIRVIEW RIDGES HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 6545 France Ave S, Suite 125, Edina, MN 55435-2357 | 9524052777 | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 6519827000 | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| Organization Legal Name | SUBURBAN RADIOLOGIC CONSULTANTS LTD |
| Physicians | 65 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jonathan P Williams | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Mark D Mcmillan | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 4050 Coon Rapids Nwblvd, Coon Rapids, MN 55433-2522 |
| Paul Robert Oler | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 6545 France Ave S, Suite 125, Edina, MN 55435-2357 |
| Mark E Wilson | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| Brian F Decesare | Interventional Radiology | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| Jennifer Williams | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| Karl T Nelsen | Physician Assistant | Suburban Radiologic Consultants Ltd | 14000 Nicollet Ave, Suite 204, Burnsville, MN 55337-5796 |
| John A Coburn | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 6545 France Ave S, Suite 125, Edina, MN 55435-2357 |
| David A Asinger | Diagnostic Radiology | Suburban Radiologic Consultants Ltd | 11225 Ulysses St Ne, Suite 110, Blaine, MN 55434-4261 |
| Fareed Siddiqui | Interventional Radiology | Suburban Radiologic Consultants Ltd | 6545 France Ave S, Suite 125, Edina, MN 55435-2357 |
| Street Address |
5200 FAIRVIEW BLVD |
| City | WYOMING |
| State | MN |
| Zip | 55092-8013 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Andrew Caraganis | Pulmonary Disease | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Julie L Becker | Obstetrics/gynecology | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| John B Buren | Podiatry | Fairview Health Services | 5200 Fairview Blvd, Suite 1300, Wyoming, MN 55092-8013 |
| Oluwakemi T Olowoyo | Family Medicine | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| David C Drage | Emergency Medicine | Fairview Health Services | 5200 Fairview Blvd, Suite 1300, Wyoming, MN 55092-8013 |
| John T Northwood | Family Medicine | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| David J Tosteson | Family Medicine | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| David D Laxson | Cardiovascular Disease (cardiology) | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Molly C Vaishnav | Nurse Practitioner | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Sheila R Reash | Certified Registered Nurse Anesthetist (crna) | North Metro Anesthesia Services P.a. | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John Patrick Eikens | Family Medicine | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Gregory A Helmer | Interventional Cardiology | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Deborah K Strand | Family Medicine | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Henri Roukoz | Cardiovascular Disease (cardiology) | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Gloria J Dullinger-brown | Certified Registered Nurse Anesthetist (crna) | North Metro Anesthesia Services P.a. | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Michael D Eichler | Ophthalmology | Tec LLC | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Heidi L Ruzek | Certified Registered Nurse Anesthetist (crna) | North Metro Anesthesia Services P.a. | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Antonette M Trapp | Nurse Practitioner | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Kent N Yoshida | Certified Registered Nurse Anesthetist (crna) | North Metro Anesthesia Services P.a. | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Li Ge | Medical Oncology | Fairview Health Services | 5200 Fairview Blvd, Wyoming, MN 55092-8013 |
| Find all physicians in zip 55092 | |||
| City | WYOMING |
| Zip Code | 55092 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | WYOMING + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Kevin D Gustafson.
| 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.