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Matthew Chase Lustig
Student in an Organized Health Care Education/Training Program in Columbia, South Carolina
NPI 1679006746

Matthew Chase Lustig is a Student in an Organized Health Care Education/Training Program based in Greenville, SC. Matthew Chase Lustig practices in Columbia, SC. The NPI Number for Matthew Chase Lustig is 1679006746 and holds a License No. 87712 (South Carolina).

The current practice location address for Matthew Chase Lustig is 9 Richland Medical Park Dr Ste 110, Columbia, SC and can be reached out via phone at 803-434-7951 and via fax at 803-758-0134.

Location: 9 Richland Medical Park Dr Ste 110, Columbia, SC, 29601-2842
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679006746
Provider Name
Matthew Chase Lustig
Credential
Provider Entity Type
Individual
Gender
Male
Address
9 Richland Medical Park Dr Ste 110, Columbia, SC, 29601-2842
Phone Number
803-434-7951
Fax Number
803-758-0134
Provider Enumeration Date
04/06/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
9 Richland Medical Park Dr Ste 110
City
Columbia
State
South Carolina
Zip
29203-6859
Phone Number
803-434-7951
Fax Number
803-758-0134
person
Provider Business Mailing Address Details
Address
9 Richland Medical Park Dr Ste 110
City
Columbia
State
South Carolina
Zip
29203-6859
Phone Number
803-434-7951
Fax Number
803-758-0134
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
Neurodevelopmental Disabilities
Taxonomy
2080P0008X
License No.
()
Definition
A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
87712 (South Carolina)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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