Provider Demographics
NPI:1871522151
Name:ESCUDER, CLARA EMILIA (MD)
Entity type:Individual
Prefix:DR
First Name:CLARA
Middle Name:EMILIA
Last Name:ESCUDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5617 RAMSEY ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1423
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:3505 CONVERSE DR STE 200
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6132
Practice Address - Country:US
Practice Address - Phone:717-812-3040
Practice Address - Fax:717-812-3049
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01689208000000X
PAMD426435208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1456143OtherHIGHMARK BLUE SHIELD
PA20046323OtherAH MERCY-WMG RATHTON RD
NC319515OtherMEDCOST LLC
NC1154757OtherUNITED HEALTHCARE
NC4067311OtherAETNA HEALTH PLANS
PAP006384OtherGATEWAY-WMG
PA015130OtherJOHNS HOPKINS
PA101404671Medicaid
NC1871522151OtherHEALTHGRAM
PA100446OtherGEISINGER
PA167539OtherUNISON-WMG
NC1871522151Medicaid
PA2136736OtherMAMSI-WMG
PA4067311OtherAETNA
NC1871522151OtherHEALTHNET FEDERAL SERVICES / TRICARE NORTH
NC1871522151OtherHEALTHSMART
PA20046324OtherAH MERCY-WMG WINDSOR RD
NC4469931OtherCIGNA
PA50049455OtherCAPITAL BLUE CROSS-WMG
NC62700790OtherPHCS/MULTIPLAN
NC670048OtherCOVENTRY/1ST HEALTH
NCFH1102210OtherFIRST CAROLINA CARE
NC1871522151OtherHUMANA
NC19MQBOtherBCBS OF NC
MD350783OtherCAREFIRST MD BCBS
NCFH1102210OtherFIRST CAROLINA CARE
NC4067311OtherAETNA HEALTH PLANS