Individual
TOD MARTIN HANOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 PATEWOOD DR, SUITE C300, GREENVILLE, SC 29615-3593
(864) 454-8272
(864) 454-2875
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6303
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
14730
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
576007863200
BCBS
SC
05
—
N00826
—
SC
01
—
P00441281
RR MEDICARE
SC
01
—
P00817221
RR MEDICARE
SC
Enumeration date
08/16/2006
Last updated
02/01/2018
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