Individual
VICTORIA IVELLISE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060-0001
(202) 865-6100
Mailing address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060-0001
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
317706
NY
Other
Enumeration date
04/01/2015
Last updated
09/18/2023
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