Provider Demographics
NPI:1073535605
Name:DARBY, CLARENCE STEWART (PA PHD)
Entity Type:Individual
Prefix:DR
First Name:CLARENCE
Middle Name:STEWART
Last Name:DARBY
Suffix:
Gender:M
Credentials:PA PHD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:140 WILDEWOOD PARK DR STE 107
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-4312
Mailing Address - Country:US
Mailing Address - Phone:803-722-4988
Mailing Address - Fax:803-656-8135
Practice Address - Street 1:140 WILDEWOOD PARK DR STE 107
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-4312
Practice Address - Country:US
Practice Address - Phone:803-722-4988
Practice Address - Fax:803-656-8135
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC440363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical