Individual
DR. NICHOLAS SAMUEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 224-5170
(540) 344-2950
Mailing address
2331 FRANKLIN RD SW, ROANOKE, VA 24014-1111
(540) 224-5170
(540) 344-2950
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
0101264909
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2014
Last updated
12/10/2020
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