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Contact Information

LIBERTY DOCTORS LLC DBA EBB TIDE COMPREHENSIVE CARE
669 MARINA DR STE A2
CHARLESTON, SC29492-7573
 Phone: 843-491-9955
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Vascular Specialist

246XC2903X
Indicates primary specialty

NPI Profile & details for LIBERTY DOCTORS LLC DBA EBB TIDE COMPREHENSIVE CARE · (Female)

NPI Number 1588434245
Status Active
Credentials
Entity Individual
Enumeration date 01/04/2024
Last updated 12/19/2025 - About 6 months ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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