Organization
LIBERTY DOCTORS LLC DBA EBB TIDE COMPREHENSIVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHELSEY DEVER (CREDENTIALING COORDINATOR)
(843) 225-8320
Entity
Organization
Contact information
Practice address
669 MARINA DR STE A2, CHARLESTON, SC 29492-7573
(843) 491-9955
Mailing address
669 MARINA DR STE A, CHARLESTON, SC 29492-7542
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
246XC2903X
Vascular Specialist/Technologist Cardiovascular
—
—
Other
Enumeration date
01/04/2024
Last updated
12/19/2025
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