Individual
DR. EDWARD C CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
311 W 24TH ST, SUITE 402, ERIE, PA 16502-2665
(814) 453-6687
(814) 456-4676
Mailing address
311 W 24TH ST, SUITE 402, ERIE, PA 16502-2665
(814) 453-6687
(814) 456-4676
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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