Individual
ADAM D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1600 MEDICAL DR, LAURINBURG, NC 28352-5524
(910) 277-9164
(910) 277-9189
Mailing address
PO BOX 2257, LAURINBURG, NC 28353-2257
(910) 277-9164
(910) 277-9189
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0010-01061
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-01061
LICENSE
NC
Enumeration date
10/05/2007
Last updated
05/16/2011
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