Organization
W BRUCE CLARK MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE MCNAMARA (MEDICAL BILLER)
(518) 783-1472
Entity
Organization
Contact information
Practice address
585 NEW LOUDON RD, LATHAM, NY 12110-5701
(518) 783-1472
(518) 783-1605
Mailing address
585 NEW LOUDON RD, LATHAM, NY 12110-5701
(518) 783-1472
(518) 783-1605
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00798590
—
NY
05
—
01698282
—
NY
05
—
01866453
—
NY
05
—
02425116
—
NY
Enumeration date
05/10/2007
Last updated
02/26/2008
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