Individual
LAURA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 537-0752
Mailing address
526 E 39TH ST, BALTIMORE, MD 21218-1901
(410) 433-8053
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0001473
MD
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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