Individual
NICHOLAS THOMAS SISOFO IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
709 OLD TROLLEY RD, SUMMERVILLE, SC 29485-5203
(843) 900-6767
(843) 285-5916
Mailing address
709 OLD TROLLEY RD, SUMMERVILLE, SC 29485-5203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/02/2021
Last updated
04/30/2024
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