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Individual
DR. EDWARD C CLARK
Active
Individual
DR. EDWARD C CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD055901L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015345390001
—
PA
01
—
208292
UPMC
PA
01
—
390004949
MEDICARE PALMETTO
PA
01
—
776463
HIGHMARK PA BS
PA
Enumeration date
07/22/2005
Last updated
11/13/2009
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