Individual
M. JUSTINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
600 RIDGELY AVE STE 214, ANNAPOLIS, MD 21401-8804
(410) 573-2290
Mailing address
600 RIDGELY AVE STE 214, ANNAPOLIS, MD 21401-8804
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
H0041992
MD
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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