Individual
MICHELLE SUZANNE LUSK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
107 W COLLEGE AVE, HARTSVILLE, SC 29550-4113
(843) 639-6012
(843) 536-4194
Mailing address
PO BOX 1763, HARTSVILLE, SC 29551-1763
(843) 639-6012
(843) 536-4194
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
22891
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228916
—
SC
Enumeration date
07/06/2006
Last updated
11/16/2023
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