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Organization
BRANDON C BULTSMA, DPM, PC
Active
Organization
BRANDON C BULTSMA, DPM, PC
Active
Other names
Bluewater Wound Care Clinic, Bluewater Foot and Ankle Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON BULTSMA DPM (PRESIDENT)
(854) 444-3129
Entity
Organization
Contact information
Practice address
2142 EXECUTIVE HALL RD, CHARLESTON, SC 29407-8713
(854) 444-3129
Mailing address
2142 EXECUTIVE HALL RD, CHARLESTON, SC 29407-8713
(854) 444-3129
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
04/19/2018
Last updated
06/22/2026
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