Provider Demographics
NPI:1033261060
Name:DAUB, CLIFFORD WADE (PA-C)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:WADE
Last Name:DAUB
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 DUKE MEDICINE CIR # 1B1C
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-4000
Mailing Address - Country:US
Mailing Address - Phone:919-660-3006
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIR # 1B1C
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-8106
Practice Address - Country:US
Practice Address - Phone:919-660-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06133363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant