IndividualActive
Matthew Lustig
NPI 1679006746 · Pediatric Neurodevelopmental Disabilities Physician · Columbia, SC
Provider details
- NPI number
- 1679006746
- Entity type
- Individual
- Primary specialty
- Pediatric Neurodevelopmental Disabilities PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- 87712 (SC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Student, Health Care
Practice location
9 Richland Medical Park Dr Ste 110
Columbia, SC 29203-6859
Phone: (803) 434-7951
Fax: (803) 758-0134
Approximate (ZIP-level) locationGet directions
Mailing address
300 E Mcbee Ave Fl 4
Greenville, SC 29601-2842
Additional practice locations (1)
- 625 19th St SBirmingham, AL 35233-1900Phone: (205) 996-7859
Registry dates
- Enumerated
- 2017-04-06
- Last updated
- 2022-06-07
- Certified
- 2022-06-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.