Organization
LIBERTY DOCTORS, LLC
Active
Parent organization
LIBERTY DOCTORS LLC
Other names
Carolina Family Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIBERTY DOCTORS LLC
Authorized official
CHELSEY DEVER (CREDENTIALING COORDINATOR)
(843) 225-8320
Entity
Organization
Contact information
Practice address
100 SPRINGHALL DR, GOOSE CREEK, SC 29445-5335
(843) 572-8201
(843) 797-8491
Mailing address
PO BOX 13955, CHARLESTON, SC 29422-3955
(843) 225-8304
(843) 225-3549
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GP0189
MEDICAID GROUP NUMBER
SC
05
—
GP0189
—
SC
05
—
GP6738
—
SC
Enumeration date
05/11/2006
Last updated
12/15/2025
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