Individual
DR. ALICE S LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 232-3327
(574) 232-3369
Mailing address
211 N EDDY ST, SOUTH BEND, IN 46617-2808
(574) 232-3327
(574) 232-3369
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01050252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200209940
—
IN
Enumeration date
10/26/2005
Last updated
04/05/2020
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