Individual
DENISE MAUREEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
24690 BENCH LN, OAK CREEK, CO 80467-8545
(970) 879-7241
Mailing address
24690 BENCH LN, OAK CREEK, CO 80467-8545
(970) 879-7241
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30559
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2123158
—
IA
01
—
24232
WELLMARK
IA
Enumeration date
08/26/2005
Last updated
09/16/2009
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