Individual
DR. GAVIN KESTRAL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 IRVING ST NW STE NA1177, WASHINGTON, DC 20010-3017
(202) 373-9969
Mailing address
110 IRVING ST NW STE NA1177, WASHINGTON, DC 20010-3017
(202) 373-9969
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101288809
VA
207P00000X
Emergency Medicine Physician
Primary
D0106561
MD
207P00000X
Emergency Medicine Physician
MD60005590
DC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
04/25/2026
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