Individual
ANDREA MAY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4951 BUSINESS PARK BLVD, ANCHORAGE, AK 99503-7174
(907) 743-7200
Mailing address
4951 BUSINESS PARK BLVD, ANCHORAGE, AK 99503-7174
(907) 743-7200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
102892
AK
207QA0505X
Adult Medicine Physician
4951
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1579312
—
AK
Enumeration date
06/20/2012
Last updated
05/22/2024
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