Individual
DR. JOHN ELLIOTT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 IRVING ST NW, STE 412, WASHINGTON, DC 20422-0001
(202) 507-9952
(202) 836-6921
Mailing address
50 IRVING ST NW, STE 412, WASHINGTON, DC 20422-0001
(202) 507-9952
(202) 836-6921
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD14155
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00247377
—
DC
01
—
7666
CAREFIRST
DC
Enumeration date
10/06/2006
Last updated
02/10/2017
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