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Alicia Gustafson, D.O. — NPI 1417210790, Bloomington, MN | NPI Central

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NPI 1417210790

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Alicia Gustafson, D.O.

NPI 1417210790 · Sports Medicine (Internal Medicine) Physician · Bloomington, MN

Provider details

NPI number: 1417210790
Entity type: Individual
Primary specialty: Sports Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
Credential: D.O.
Sex: Female
Sole proprietor: No
License: S9140 (TX)

Specialties & taxonomies

Sports Medicine (Internal Medicine) PhysicianPrimary207RS0010XLicense 75542 (MN)
Allopathic & Osteopathic Physicians
Family Medicine Physician207Q00000XLicense S9140 (TX)
Allopathic & Osteopathic Physicians
Sports Medicine (Family Medicine) Physician207QS0010XLicense S9140 (TX)
Allopathic & Osteopathic Physicians

Practice location

8100 Northland Dr

Bloomington, MN 55431-4800

Phone: (952) 831-8742

Approximate (ZIP-level) locationGet directions

More MN providers

Mailing address

8170 33rd Ave S # Ms 21110q

Bloomington, MN 55425-4516

Additional practice locations (1)

1976 Texan Dr., Suite 106
Justin, TX 76247
Phone: (682) 212-9020

Registry dates

Enumerated: 2012-06-21
Last updated: 2024-05-10
Certified: 2024-05-10

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.