Individual
DR. STEPHEN RAY SISCO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1055 RIBAUT ROAD, SUITE 30, BEAUFORT, SC 29902-5447
(843) 524-8171
(843) 525-6613
Mailing address
1055 RIBAUT ROAD, SUITE 30, BEAUFORT, SC 29902-5447
(843) 524-8171
(843) 525-6613
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19943
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T39777
—
SC
Enumeration date
02/06/2006
Last updated
07/08/2007
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