Individual
DR. MARC L. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
870 STATE FARM RD, STE 102, BOONE, NC 28607-4861
(828) 264-0029
(828) 265-3305
Mailing address
870 STATE FARM RD, STE 102, BOONE, NC 28607-4861
(828) 264-0029
(828) 265-3305
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
16869
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3702765
MEDICARE GROUP NUMBER
—
01
—
62-1482379
TAX ID
—
Enumeration date
08/21/2006
Last updated
01/07/2010
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