Clark, Susan Christine

Clark, Susan Christine is an sole proprietor health care provider with primary practice located at Naval Medical Center Portsmouth 620 John Paul Jones Circle, Portsmouth VA 23708. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Clark, Susan Christine can be contacted via phone (757) 953-9759.

Contact Information

Primary practice address
Naval Medical Center Portsmouth 620 John Paul Jones Circle Portsmouth VA 23708
Fax: (757) 953-0845
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 2011-00718 North Carolina
Allopathic & Osteopathic Physicians / Surgery 208600000X MD426779 Pennsylvania
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101253279 Virginia

Profile Details

NPI number 1104096650
LBN Legal business name Clark, Susan Christine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 11th, 2008
Last updated Feb 20th, 2024 - about 10 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104096650 NPPES
North Carolina MEDICAID 5918139
North Carolina Other 163WH

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