Provider Demographics
NPI:1043322753
Name:LUSTER, KAREN YVONNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:YVONNE
Last Name:LUSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 PHOENIX BLVD
Mailing Address - Street 2:STE 700
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349
Mailing Address - Country:US
Mailing Address - Phone:470-369-7800
Mailing Address - Fax:470-369-7801
Practice Address - Street 1:1720 PHOENIX BLVD
Practice Address - Street 2:STE 700
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349
Practice Address - Country:US
Practice Address - Phone:470-369-7800
Practice Address - Fax:470-369-7801
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053580207R00000X
GA53580207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine