Individual
ELIZABETH ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1000 BLYTHE BLVD, SUITE 601, CHARLOTTE, NC 28203-5812
(704) 355-7874
(704) 355-5619
Mailing address
1204 COPPER HILL ROAD, PO BOX 169, GLEN HAVEN, CO 80532
(970) 372-8832
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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