Dr Marcus Michael Gustafson, DDS is a medicare enrolled "Dentist" provider in Lakeland, Minnesota. His current practice location is
16678 7th St S, Lakeland, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(612) 867-6177.
Dr Marcus Michael Gustafson is licensed to practice in Minnesota (license number D8384) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1164489654.
Healthcare Provider's Profile
Full Name | Dr Marcus Michael Gustafson |
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Gender | Male |
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Speciality | Dentist |
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Location | 16678 7th St S, Lakeland, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1164489654
- Provider Enumeration Date: 04/27/2006
- Last Update Date: 10/23/2015
Medicare PECOS Information:
- PECOS PAC ID: 3173824729
- Enrollment ID: I20151223001940
Medical Identifiers
Medical identifiers for Dr Marcus Michael Gustafson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164489654 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | D8384 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Marcus Michael Gustafson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Marcus Michael Gustafson, DDS 16678 7th St S, Lakeland, MN 55043-9531 Ph: (612) 867-6177 | Dr Marcus Michael Gustafson, DDS 16678 7th St S, Lakeland, MN 55043-9531 Ph: (612) 867-6177 |
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