Robert Edward Clark MD

NPI 1033372727 - Internal Medicine - 207R00000X

NPI Details
NPI 1033372727
Gender Male
Enumeration Date 07/03/2008
Last Updated 06/18/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
1302 FRANKLIN AVE
SUITE 4800
NORMAL IL, 61761-3551, US
Phone (309) 454-5900
Fax (309) 454-2820
Business Location
1302 FRANKLIN AVE
SUITE 4800
NORMAL IL, 61761-3551, US
Phone (309) 454-5900
Fax (309) 454-2820
Toxanomy
Taxonomy Code 207R00000X
License State Pennsylvania
License Number MT190170
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According to our database, Dr. Robert Edward Clark MD NPI is 1033372727, taxonomy code is 207R00000X and license number is MT190170, license state is located at Pennsylvania. Robert Edward Clark MD physically located at 1302 Franklin Ave, Normal IL, 61761-3551. NPI Number Robert Edward Clark MD has the Individual type.

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1033372727 NPI number is provided on an as is basis without warranty of any kind. 1033372727 is maintained by the National Plan & Provider Enumeration System. The contents of Robert Edward Clark MD are for informational purposes only.