Individual
CALEB MATTHEW LUSK
Active
Individual
CALEB MATTHEW LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
69006
CT
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
A165385
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004217099
—
CT
05
—
008039745
—
CT
05
—
008056033
—
CT
05
—
008056168
—
CT
05
—
008068298
—
CT
05
—
008103790
—
CT
Enumeration date
03/26/2018
Last updated
03/28/2023
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