Individual
CLARK BRYAN BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 MEDICAL CENTER CIR STE 302, FISHERSVILLE, VA 22939-2273
(540) 245-7400
(540) 245-7401
Mailing address
PO BOX 388, FISHERSVILLE, VA 22939-0388
(540) 932-5162
(540) 932-5875
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
0101263843
VA
207T00000X
Neurological Surgery Physician
37372
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64054273
—
KY
Enumeration date
09/26/2006
Last updated
08/28/2023
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