Individual
DONOVAN DERYL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
382 TAYLOR DR, DANVILLE, VA 24541
(434) 773-4240
(434) 773-4241
Mailing address
382 TAYLOR DR, DANVILLE, VA 24541
(434) 773-4240
(434) 773-4241
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
VA 0101057639
VA
Other
Enumeration date
03/24/2006
Last updated
01/08/2008
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