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Individual

DR. CLAYTON GREGORY MAZOUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7035 SAINT ANDREWS RD, COLUMBIA, SC 29212-1177
(803) 749-0924
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2203

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
93192
SC
207Q00000X
Family Medicine Physician
MD.200841
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1072923
LA
Enumeration date
06/13/2007
Last updated
03/21/2025
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