| Liberty Doctors, Llc | |
|
418 Folly Rd Ste A Charleston SC 29412-2625 | |
| (843) 795-5362 | |
| (843) 795-1921 |
| Full Name | Liberty Doctors, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 418 Folly Rd Ste A, Charleston, South Carolina |
| Authorized Official Name and Position | Sara Elizabeth Maynor-hardy (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 8432258320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Doctors, Llc Po Box 13955 Charleston SC 29422-3955 Ph: (843) 225-8304 | Liberty Doctors, Llc 418 Folly Rd Ste A Charleston SC 29412-2625 Ph: (843) 795-5362 |
| NPI Number | 1689051369 |
|---|---|
| Provider Enumeration Date | 05/01/2015 |
| Last Update Date | 09/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689051369 | NPI | - | NPPES |
| GP6738 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (South Carolina) | Primary |
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