Organization
LIBERTY DOCTORS LLC D/B/A FAMILY FIRST MEDICAL CARE
Active
Other names
Health Care Consultants of Charleston
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH MAYNOR-HARDY (CREDENTIALING COORDINATOR)
(843) 225-8320
Entity
Organization
Contact information
Practice address
2270 ASHLEY CROSSING DR STE 150, CHARLESTON, SC 29414-5702
(843) 766-1936
(843) 766-1206
Mailing address
PO BOX 13955, CHARLESTON, SC 29422-3955
(843) 225-8320
(843) 225-3549
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
21948
SC
207Q00000X
Family Medicine Physician
Primary
22266
SC
207Q00000X
Family Medicine Physician
24446
SC
207Q00000X
Family Medicine Physician
6385
SC
207R00000X
Internal Medicine Physician
5942
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194667
—
SC
01
—
247253076
BCBS
SC
01
—
247743969
BCBS
SC
01
—
257064675
BCBS
SC
01
—
280508389
BCBS
SC
01
—
400560049
BCBS
SC
01
—
B1015
MEDCOST
SC
05
—
GP3158
—
SC
Enumeration date
08/08/2006
Last updated
09/21/2017
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