Organization
LIBERTY DOCTORS LLC
Active
Parent organization
LIBERTY DOCTORS, LLC
Other names
Viduya Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIBERTY DOCTORS, LLC
Authorized official
CHELSEY DEVER (CREDENTIALING COORDINATOR)
(843) 697-5168
Entity
Organization
Contact information
Practice address
2175 ASHLEY PHOSPHATE RD STE D, NORTH CHARLESTON, SC 29406-4181
(843) 779-6444
(843) 779-6438
Mailing address
2175 ASHLEY PHOSPHATE RD STE D, NORTH CHARLESTON, SC 29406-4181
(843) 779-6444
(843) 779-6438
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A634
MEDICARE PART B
SC
05
—
GP6738
—
SC
Enumeration date
11/06/2020
Last updated
03/26/2026
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