Maxine Rae Gustafson, PA-C

NPI #1083127203 in Edina, Minnesota

Provider Information

NPI Number: 1083127203
Entity Type: Individual
Name: Maxine Rae Gustafson, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Nov 9, 2017
Last Updated: Nov 9, 2017

Practice Location

Address: 6525 FRANCE AVE S STE 200
City: Edina
State: Minnesota
ZIP Code: 55435-2176
Phone: (952) 927-6501

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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