Individual
DR. CHARLES ROBERT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1725 N SKY GLEN PATH, HERNANDO, FL 34442-6187
(352) 270-8425
Mailing address
1725 N SKY GLEN PATH, HERNANDO, FL 34442-6187
(352) 270-8425
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D19029
MD
Other
Enumeration date
04/26/2007
Last updated
01/02/2008
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