Individual
DR. SUSAN CHRISTINE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
NAVAL MEDICAL CENTER PORTSMOUTH, 620 JOHN PAUL JONES CIRCLE, PORTSMOUTH, VA 23708
(757) 953-9759
(757) 953-0845
Mailing address
NAVAL MEDICAL CENTER PORTSMOUTH, 620 JOHN PAUL JONES CIRCLE, PORTSMOUTH, VA 23708-9971
(757) 953-9759
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101253279
VA
208600000X
Surgery Physician
2011-00718
NC
208600000X
Surgery Physician
MD426779
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163WH
BCBSNC
NC
05
—
5918139
—
NC
Enumeration date
03/11/2008
Last updated
02/20/2024
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