Individual
RODERICK CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 UNIVERSITY DR RM C4830, HERSHEY, PA 17033-2360
(717) 531-1132
(717) 531-4475
Mailing address
500 UNIVERSITY DR RM C4830, HERSHEY, PA 17033-2360
(717) 531-1132
(717) 531-4475
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD478170
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CAMD-0160-2520
CANADIAN MEDICAL IDENTIFICATION NUMBER (MINC)
—
Enumeration date
09/09/2022
Last updated
09/09/2022
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