Provider Demographics
NPI:1033193024
Name:LUTHER, STEPHEN SEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:SEAN
Last Name:LUTHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 WILLIAM HILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2497
Mailing Address - Country:US
Mailing Address - Phone:843-738-4800
Mailing Address - Fax:843-738-4801
Practice Address - Street 1:460 WILLIAM HILTON PKWY
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2497
Practice Address - Country:US
Practice Address - Phone:843-738-4800
Practice Address - Fax:843-738-4801
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042750A207R00000X
SC29750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200000020AMedicaid
SC297501Medicaid
SCAA21296305Medicare PIN
IN148600Medicare ID - Type Unspecified
SC297501Medicaid