Individual
CHARLES G. SHISSIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 MIDTOWN DR, BEAUFORT, SC 29906-5200
(843) 770-0404
(803) 522-3515
Mailing address
300 MIDTOWN DR, BEAUFORT, SC 29906-5200
(843) 770-0404
(803) 522-3515
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
21645
SC
2084N0400X
Neurology Physician
MD11448R
LA
2084P0800X
Psychiatry Physician
21645
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216457
—
SC
Enumeration date
08/11/2006
Last updated
10/21/2025
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