| Liberty Doctors, Llc | |
|
297 Seven Farms Dr Ste 202 Daniel Island SC 29492-7553 | |
| (843) 936-4470 | |
| (843) 256-6877 |
| Full Name | Liberty Doctors, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 297 Seven Farms Dr Ste 202, Daniel Island, South Carolina |
| Authorized Official Name and Position | Sara Elizabeth Maynor-hardy (CREDENTIALING MANAGER) |
| 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) 225-8320 | Liberty Doctors, Llc 297 Seven Farms Dr Ste 202 Daniel Island SC 29492-7553 Ph: (843) 936-4470 |
| NPI Number | 1053954909 |
|---|---|
| Provider Enumeration Date | 10/23/2019 |
| Last Update Date | 10/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053954909 | NPI | - | NPPES |
| A634 | Other | SC | MEDICARE PTAN |
| GP6738 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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