Healthcare Provider Details

I. General information

NPI: 1053319400
Provider Name (Legal Business Name): JOHN WILLIAMS PLYLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 11/16/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9313 MEDICAL PLAZA DR SUITE 310
CHARLESTON SC
29406-9155
US

IV. Provider business mailing address

PO BOX 118008
CHARLESTON SC
29423-8008
US

V. Phone/Fax

Practice location:
  • Phone: 843-569-1856
  • Fax: 843-569-1879
Mailing address:
  • Phone: 843-569-1856
  • Fax: 843-569-1879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number12363
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number12363
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: