Individual
GERALD H. CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1285 HEMBREE RD, STE 100, ROSWELL, GA 30076-5715
(770) 442-1050
(770) 442-9618
Mailing address
1285 HEMBREE RD, STE 100, ROSWELL, GA 30076-5715
(770) 442-1050
(770) 442-9618
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
026083
GA
Other
Enumeration date
06/24/2005
Last updated
07/09/2007
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