Organization
LIBERTY DOCTORS LLC
Active
Other names
Simple Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CHELSEY DEVER (CREDENTIALING COORDINATOR)
(843) 225-8320
Entity
Organization
Contact information
Practice address
1315 ASHLEY RIVER RD, CHARLESTON, SC 29407-5315
(854) 429-1175
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
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A634
MEDICARE PTAN
SC
05
—
GP6738
—
SC
Enumeration date
03/21/2019
Last updated
12/15/2025
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