Provider Demographics
NPI:1083364525
Name:CLAWSON, REBECCA CANDLER (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CANDLER
Last Name:CLAWSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 WRENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-4650
Mailing Address - Country:US
Mailing Address - Phone:803-239-7323
Mailing Address - Fax:
Practice Address - Street 1:401 N 11TH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1901
Practice Address - Country:US
Practice Address - Phone:840-828-9361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-27
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program