Individual
DR. MARILYN R. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 NORTHAMPTON STREET, BOSTON, MA 02118-4010
(617) 433-9601
(617) 445-6538
Mailing address
30 NORTHAMPTON STREET, BOSTON, MA 02118-4010
(617) 433-9601
(617) 445-6538
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44535
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6168213
—
MA
Enumeration date
08/31/2006
Last updated
10/22/2015
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