Provider Demographics
NPI:1104988278
Name:VANMARTER, SEAN EDWARD (DPM)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:EDWARD
Last Name:VANMARTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55B SHERIDAN PARK CIR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-6025
Mailing Address - Country:US
Mailing Address - Phone:843-815-5092
Mailing Address - Fax:843-815-5094
Practice Address - Street 1:55B SHERIDAN PARK CIR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-6025
Practice Address - Country:US
Practice Address - Phone:843-815-5092
Practice Address - Fax:843-815-5094
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2022-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC511213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC480028016OtherRAILROAD MEDICARE
SCPD5113Medicaid
SCU67783Medicare UPIN
SCU67783Medicare UPIN