Individual
MARY E CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
163 VETERANS DRIVE, WHITE RIVER JUNCTION, VT 05009-4728
(508) 776-8014
Mailing address
215 N MAIN ST, WHITE RIVER JUNCTION, VT 05009-0001
(508) 776-8014
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
27610
NE
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
282335
MA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
LP05113
RI
Other
Enumeration date
08/28/2012
Last updated
09/17/2021
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