Organization
LIBERTY DOCTORS LLC
Active
Other names
HOPE CLINIC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHELSEY DEVER (CREDENTIALING COORDINATOR)
(843) 225-8320
Entity
Organization
Contact information
Practice address
110 EXECUTIVE PKWY, MONCKS CORNER, SC 29461-3930
(843) 899-9099
(888) 318-5567
Mailing address
110 EXECUTIVE PKWY, MONCKS CORNER, SC 29461-3930
(843) 408-4171
(888) 318-5567
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20234
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202346
—
SC
01
—
4225947
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/17/2006
Last updated
12/15/2025
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