Provider Demographics
NPI:1598773418
Name:CLARA M HIGGINS DO PA
Entity Type:Organization
Organization Name:CLARA M HIGGINS DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGEON PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DO PA
Authorized Official - Phone:302-644-9644
Mailing Address - Street 1:110 ANGLERS ROAD
Mailing Address - Street 2:UNIT 104 SAFE HARBOR
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958
Mailing Address - Country:US
Mailing Address - Phone:302-644-9644
Mailing Address - Fax:302-644-9646
Practice Address - Street 1:110 ANGLERS ROAD
Practice Address - Street 2:UNIT 104 SAFE HARBOR
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958
Practice Address - Country:US
Practice Address - Phone:302-644-9644
Practice Address - Fax:302-644-9646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000014382Medicaid
DE1000014382Medicaid
G00864Medicare ID - Type Unspecified