Individual
KYLE LIBBEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9313 MEDICAL PLAZA DR STE 202, N CHARLESTON, SC 29406-9176
(843) 572-1200
(843) 553-0424
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5881
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
90431
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889417
—
SC
Enumeration date
10/18/2017
Last updated
04/10/2026
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