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Individual

WILLIAM PATRICK CLARK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
110 WIMBLEDON SQ, SUITE E, CHESAPEAKE, VA 23320
(757) 436-2995
(757) 436-2912
Mailing address
856 J CLYDE MORRIS BLVD, SUITE A, NEWPORT NEWS, VA 23601-1318

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0101036704
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487619656
VA
Enumeration date
04/19/2006
Last updated
10/03/2013
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