Provider Demographics
NPI:1124483722
Name:BIXLER, CHARMIAN WEBB (MSPAS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:CHARMIAN
Middle Name:WEBB
Last Name:BIXLER
Suffix:
Gender:F
Credentials:MSPAS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 STATION 22 1/2 ST
Mailing Address - Street 2:
Mailing Address - City:SULLIVANS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29482-9756
Mailing Address - Country:US
Mailing Address - Phone:843-883-3176
Mailing Address - Fax:843-883-3459
Practice Address - Street 1:306 STATION 22 1/2 ST
Practice Address - Street 2:
Practice Address - City:SULLIVANS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29482-9756
Practice Address - Country:US
Practice Address - Phone:843-883-3176
Practice Address - Fax:843-883-3459
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-23
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2491363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant