Clark, David A
Clark, David A is an individual health care provider with primary practice located at 4600 Lake Boone Trail Suite 100, Raleigh NC 27607-7529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Clark, David A can be contacted via phone (919) 787-1374.Contact Information
Primary practice address
4600 Lake Boone Trail Suite 100
Raleigh NC 27607-7529
Phone: (919) 787-1374
Fax: (919) 788-9007
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 35295 | Virginia |
Profile Details
| NPI number | 1396793949 |
|---|---|
| LBN Legal business name | Clark, David A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Jul 12th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396793949 | NPPES |
| North Carolina | Other | 1050087 | UNITED HEALTHCARE |
| North Carolina | Other | 22601 | UNITED HEALTHCARE |
| North Carolina | MEDICAID | 8922601 | UNITED HEALTHCARE |
| North Carolina | Other | 040010474 | UNITED HEALTHCARE |
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