Nicholas Gustafson, | |
1222 N 23rd St, Sheboygan, WI 53081-3171 | |
(920) 457-6800 | |
Not Available |
Full Name | Nicholas Gustafson |
---|---|
Gender | Male |
Speciality | Hematology/oncology |
Experience | 10 Years |
Location | 1222 N 23rd St, Sheboygan, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508286386 | NPI | - | NPPES |
100139705 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208M00000X | Hospitalist | 02005360A (Indiana) | Secondary |
207RH0003X | Internal Medicine - Hematology & Oncology | 72979 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Aurora Sheboygan Memorial Medical Ctr | Sheboygan, WI | Hospital |
Aurora Baycare Medical Ctr | Green bay, WI | Hospital |
Aurora Medical Center - Grafton | Grafton, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Aurora Health Care Central, Inc. | 4688583677 | 5 |
Aurora Medical Group, Inc. | 6709794258 | 3269 |
Entity Name | Aurora Medical Group, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
Entity Name | Aurora Health Care Metro Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1861447179 PECOS PAC ID: 8628986536 Enrollment ID: O20040114000498 |
Entity Name | Aurora Health Care Central, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922053107 PECOS PAC ID: 4688583677 Enrollment ID: O20040308000588 |
Mailing Address | Practice Location Address |
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Nicholas Gustafson, Po Box 735044, Chicago, IL 60673-5044 Ph: () - | Nicholas Gustafson, 1222 N 23rd St, Sheboygan, WI 53081-3171 Ph: (920) 457-6800 |
Gurminder Dhillon, MD Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 3100 Superior Ave, Sheboygan, WI 53081 Phone: 920-496-4700 Fax: 816-404-0003 | |
Dr. Philip M. Detrana, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 2414 Kohler Memorial Dr, Sheboygan, WI 53081 Phone: 920-457-4461 | |
Dr. Louie Coulis, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 1414 N Taylor Dr, Sheboygan, WI 53081 Phone: 920-458-9800 Fax: 920-458-9882 | |
Mr. Muhammad Rasheed Khan Orakzai, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-2100 | |
Mr. Vinicius Klee Lopes, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 2414 Kohler Memorial Dr, Sheboygan, WI 53081 Phone: 920-457-4461 | |
Sree Ramya Punukollu, Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-2100 | |
Dr. Rachael Bree Hosein, MBBS Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 2414 Kohler Memorial Dr, Sheboygan, WI 53081 Phone: 920-457-4461 |