Individual
RILEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
RL14170
ND
208M00000X
Hospitalist Physician
Primary
15687
ND
Other
Enumeration date
07/18/2016
Last updated
11/17/2021
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