Provider Demographics
NPI:1285228650
Name:WEBSTER, SEAN-LUKE MICHAEL (PHARM D)
Entity Type:Individual
Prefix:
First Name:SEAN-LUKE
Middle Name:MICHAEL
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9172 DEAL ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:WENONA
Mailing Address - State:MD
Mailing Address - Zip Code:21821-1330
Mailing Address - Country:US
Mailing Address - Phone:410-784-2270
Mailing Address - Fax:
Practice Address - Street 1:2132 OLD SNOW HILL RD
Practice Address - Street 2:
Practice Address - City:POCOMOKE CITY
Practice Address - State:MD
Practice Address - Zip Code:21851-2734
Practice Address - Country:US
Practice Address - Phone:410-957-9610
Practice Address - Fax:410-957-9612
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist