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LIBERTY DOCTORS LLC NPI 1144421330


NPI Information

NPI: 1144421330
Provider Name: LIBERTY DOCTORS, LLC

Doing Business As: MT. PLEASANT URGENT CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1405 BEN SAWYER BLVD
STE 105
MT PLEASANT, SC
ZIP 29464
Phone: (843) 884-8121
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LIBERTY DOCTORS, LLC is a family medicine in Mt Pleasant, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LIBERTY DOCTORS, LLC NPI is 1144421330. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mt. Pleasant Urgent Care.

The provider's business location address is:

1405 BEN SAWYER BLVD
STE 105
MT PLEASANT, SC
ZIP 29464
Phone: (843) 884-8121
Fax: (843) 884-1528

The provider's authorized official is Sara Elizabeth Maynor-hardy .
The authorized official title is Credentialing Coordinator and has the following contact phone number (843) 225-8320.

The enumeration date for this NPI number is 5/29/2007 and was last updated on 10/21/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine21530SOUTH CAROLINANo
2207P00000XEmergency Medicine21530SOUTH CAROLINANo
3207Q00000XFamily MedicineSOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G39291MEDICAIDSOUTH CAROLINA
2GP6738MEDICAIDSOUTH CAROLINA
3G02939MEDICARE UPINSOUTH CAROLINA
4G029390281MEDICARE ID-TYPE UNSPECIFIEDSOUTH CAROLINA
58749MEDICARE PINSOUTH CAROLINA
6A634MEDICARE UPINSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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