Lustgarten, Marshall D.
Lustgarten, Marshall D. is an individual health care provider with primary practice located at 1919 E Thomas Rd , Phoenix AZ 85016-7710. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Pediatric Radiology is his primary health care specialty. Lustgarten, Marshall D. can be contacted via phone (602) 546-1207.Contact Information
Primary practice address
1919 E Thomas Rd
Phoenix AZ 85016-7710
Phone: (602) 546-1207
Fax: (602) 546-1264
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | 6344 | Arizona |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 06344 | Arizona |
Profile Details
NPI number | 1871584458 |
---|---|
LBN Legal business name | Lustgarten, Marshall D. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 2nd, 2005 |
Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1871584458 | NPPES |
New Mexico | MEDICAID | 000Y6439 | |
New Mexico | MEDICAID | 256281 |
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