Individual
DR. CLARK CONSTANTINE INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
395 W 12TH AVE STE 662, COLUMBUS, OH 43210-1267
(614) 366-5978
Mailing address
395 W 12TH AVE STE 662, COLUMBUS, OH 43210-1267
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
OH
Other
Enumeration date
03/22/2023
Last updated
03/22/2023
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