Individual
DR. BRIAN M CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 WEST ST STE 25, MILLBURY, MA 01527-2677
(508) 917-6720
(508) 917-6721
Mailing address
22 WEST ST STE 25, MILLBURY, MA 01527-2677
(508) 917-6720
(508) 917-6721
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
226853
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2112191
—
MA
Enumeration date
07/28/2005
Last updated
03/01/2021
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