Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MATTHEW CHASE LUSTIG
ActiveNeurodevelopmental Disabilities · COLUMBIA, SC
Registration Details
- NPI Number
- 1679006746
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 6, 2017 (9.0446913749142 yrs)
- Last Updated
- Jun 7, 2022
- License
-
87712 (SC)
Practice Information
- Address
-
9 RICHLAND MEDICAL PARK DR STE 110COLUMBIA, SC, 292036859Browse SC providers · Browse ZIP 29203
- Phone
- 8034347951
- Fax
- 8037580134
- Primary Specialty
-
Neurodevelopmental Disabilities
2080P0008X
- Additional Specialty
- Student (Health Education/Training)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.