Provider Demographics
NPI:1053999532
Name:CLAYBORNE, CASSANDRA LEA (MD)
Entity type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:LEA
Last Name:CLAYBORNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:171 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-3641
Mailing Address - Country:US
Mailing Address - Phone:301-535-6344
Mailing Address - Fax:304-535-6618
Practice Address - Street 1:171 TAYLOR ST
Practice Address - Street 2:-
Practice Address - City:HARPERS FERRY
Practice Address - State:WV
Practice Address - Zip Code:25425-3641
Practice Address - Country:US
Practice Address - Phone:304-535-6343
Practice Address - Fax:304-535-6618
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV34074207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine