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Individual

DR. MARK GREGORY CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
216 MASON AVE, CAPE CHARLES, VA 23310-3200
(757) 331-1422
(757) 331-1624
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101038467
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346225695
VA
Enumeration date
12/09/2005
Last updated
10/03/2013
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