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Individual

DR. WILLIAM J LUSK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3300
Mailing address
342 BALDWIN RD, BIRMINGHAM, MI 48009-1360
(313) 598-0878

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101010317
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
113402922
MI
05
114604593
MI
01
WL010317
BC/BS OF MI
MI
Enumeration date
03/27/2006
Last updated
04/20/2017
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