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LIBERTY DOCTORS LLC NPI 1700162203


NPI Information

NPI: 1700162203
Provider Name: LIBERTY DOCTORS LLC

Doing Business As: MOBILE MEDICAL CONSULTANTS

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
8761 DORCHESTER RD STE 230
CHARLESTON, SC
ZIP 29420
Phone: (843) 471-2273
Get Directions

LIBERTY DOCTORS LLC is a family medicine in Charleston, 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 1700162203. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mobile Medical Consultants.

The provider's business location address is:

8761 DORCHESTER RD STE 230
CHARLESTON, SC
ZIP 29420-322
Phone: (843) 471-2273
Fax: (843) 377-8180

The provider's authorized official is Lissa C Lara .
The authorized official title is Chief Executive Officer and has the following contact phone number (843) 412-1590.

The enumeration date for this NPI number is 10/27/2011 and was last updated on 7/22/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1364SF0001XClinical Nurse SpecialistFamily Health1804SOUTH CAROLINANo
2207ZP0102XPathologyAnatomic Pathology & Clinical Pathology30704SOUTH CAROLINANo
3208000000XPediatricsSOUTH CAROLINANo
4364SF0001XClinical Nurse SpecialistFamily Health3438SOUTH CAROLINANo
5207Q00000XFamily 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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G50785MEDICAIDSOUTH CAROLINA
2SC6924A634OTHERSOUTH CAROLINAMEDICARE PTAN
3GP6738MEDICAIDSOUTH 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: 4/28/2024

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