Shane Michael Gustafson, DO
Shane Michael Gustafson, DO is a Sports Medicine in Bloomington, Minnesota. Graduated from Des Moines University of Osteopathic Medicine and Health Sciences in 2003, 23 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and Ohio.
- Years since qualifying
- 23
- Trained at
- Des Moines University of Osteopathic Medicine and Health Sciences
- Licensed in
- MN, OH
- In the registry since
- 2006
- Specialties on file
- 2
What do these letters mean?
- DO — Doctor of Osteopathic Medicine
- A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.
Practice location Address checks out
8100 Northland DrBloomington, MN 55431-4800
Phone: (952) 831-8742
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 1901 Connecticut Ave S, Sartell, MN 56377 — (320) 229-2118
Specialties & licences
| Sports Medicine (Family Medicine) Physician (primary) | Taxonomy 207QS0010X · Licence 50252 (MN) |
|---|---|
| Sports Medicine (Family Medicine) Physician | Taxonomy 207QS0010X · Licence 34-008344 (OH) |
Record details
| NPI number | 1922017623 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | DO |
| Sole proprietor | No |
| NPI enumerated | August 5, 2006 |
| Last updated in NPPES | June 17, 2021 |
| Certification date | June 17, 2021 |
| Mailing address | 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 |
Medicare enrollment
| Medicare specialty | SPORTS MEDICINE |
|---|---|
| Also practises | FAMILY PRACTICE |
| Medical school | DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES |
| Graduated | 2003 (23 years in practice) |
| Group practice | Park Nicollet Clinic — 1773 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Bloomington
-
Dr. Mohammed Arif Ibrahim, MD
8100 Northland Dr, Bloomington, MN 55431-4800 · (952) 831-8742
-
Dr. William Paulson, MD
8100 Northland Dr, Bloomington, MN 55431-4800 · (952) 831-8742
-
McKayla Schmitt, MD
8100 Northland Dr, Bloomington, MN 55431-4800 · (952) 831-8742