Provider Demographics
NPI:1487655866
Name:HIGGINS, CLARA M (DO)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:M
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33672 BAYVIEW MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1687
Mailing Address - Country:US
Mailing Address - Phone:302-703-3630
Mailing Address - Fax:302-645-8473
Practice Address - Street 1:33672 BAYVIEW MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1687
Practice Address - Country:US
Practice Address - Phone:302-703-3630
Practice Address - Fax:302-645-8473
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3108208600000X
DEC2-0024243208600000X
DEC20006485208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I022440Medicare PIN