Individual
DANIEL C CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
841 HOSPITAL RD STE 2300, INDIANA, PA 15701-3699
(724) 357-7196
(724) 357-7279
Mailing address
640 KOLTER DR, INDIANA, PA 15701-3570
(724) 357-7196
(724) 357-7279
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD046505L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018210180003
—
PA
Enumeration date
10/07/2005
Last updated
03/15/2021
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