Individual
PETER DOUGLAS CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 FRANCIS ST, RADIOLOGY BRIGHAM & WOMENS HOSPITAL, BOSTON, MA 02115
(617) 732-8098
(617) 525-7333
Mailing address
75 FRANCIS ST, RADIOLOGY BRIGHAM & WOMENS HOSPITAL, BOSTON, MA 02115
(617) 732-6505
(617) 732-6336
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
54370
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
076080
TUFTS HEALTH CARE
MA
05
—
3013465
—
MA
01
—
J05829
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/21/2005
Last updated
08/08/2012
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