Provider Demographics
NPI:1952403446
Name:HAMPTON, MARTA TORUNO (MD)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:TORUNO
Last Name:HAMPTON
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:PO BOX 31757
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29417-1757
Mailing Address - Country:US
Mailing Address - Phone:843-402-9200
Mailing Address - Fax:843-402-9700
Practice Address - Street 1:635 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7174
Practice Address - Country:US
Practice Address - Phone:843-402-9200
Practice Address - Fax:843-402-9700
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13500207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC135008Medicaid
SCF28060Medicare UPIN