Provider Demographics
NPI:1164536215
Name:HISLOP, SEAN J (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:J
Last Name:HISLOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1327 ASHLEY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5384
Mailing Address - Country:US
Mailing Address - Phone:843-577-4551
Mailing Address - Fax:843-577-8868
Practice Address - Street 1:1327 ASHLEY RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5384
Practice Address - Country:US
Practice Address - Phone:843-577-4551
Practice Address - Fax:843-577-8868
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC391572086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC391579Medicaid
SCSC81271841Medicare PIN