Basic Information
| Provider Information | |||||||||
| NPI: | 1114917895 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CLAWSON | ||||||||
| FirstName: | TERESA | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1910 | ||||||||
| Address2: | |||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226048060 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668784221 | ||||||||
| FaxNumber: | 5405364359 | ||||||||
| Practice Location | |||||||||
| Address1: | 1840 AMHERST ST | ||||||||
| Address2: | STE 4C | ||||||||
| City: | WINCHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226012808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5405367897 | ||||||||
| FaxNumber: | 5405367843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2005 | ||||||||
| LastUpdateDate: | 07/30/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | 0101053909 | VA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0110415000 | 05 | WV | MEDICAID | 541855193 | 01 | CHIR | OTHER | 1881983 | 05 | PA | MEDICAID | 400188500 | 05 | MD | MEDICAID | 541855193 | 01 | MAMSI | OTHER | 200509800 | 05 | IN | MEDICAID | 541855193 | 01 | ACORDIA | OTHER | 231639 | 01 | BS TRIGON | OTHER | 006718442 | 05 | VA | MEDICAID | 231639 | 01 | VA | ANTHEM BC/BS | OTHER | 541855193 | 01 | CHAMPUS | OTHER | 120591 | 01 | SOUTHERN HEALTH | OTHER | 541855193 | 01 | GWHC | OTHER |