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1306842182
MICHAEL J GUSTAVEL
BOISE, ID
NPI
1306842182
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207XX0005X Orthopaedic Surgery, Sports Medicine
(Licence: ID M8510)
Enumeration Date
2005-06-24
Last Update Date
2019-02-28
Business Address
Dr. MICHAEL J GUSTAVEL MD
1702 W FAIRVIEW AVE
BOISE, ID 83702-5121
Phone number: 208-850-1641
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Mailing Address
Dr. MICHAEL J GUSTAVEL MD
1188 W UNIVERSITY DR
BOISE, ID 83706-3009
Phone number: 208-336-8250
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