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NPI Code Detail

MEDICARE: SAVANNAH LUSK

MEDICARE: SAVANNAH LUSK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician36010WV

General Provider Information

NPI Number : 1134878499
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAVANNAH LUSK
Provider Business Mailing Address
First Line : 104 ALEX LN
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2952
Country : US
Telephone Number : 304-734-2040
Fax Number :
Provider Business Practice Location Address
First Line : 303 OHIO AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-2212
Country : US
Telephone Number : 681-205-8701
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2022
Last Update Date : 01/03/2026

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Directions to “ SAVANNAH LUSK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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