Individual
DR. GREG D CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
2130 HIGHWAY 35, BLDG C STE 312, SEA GIRT, NJ 08750-1010
(732) 974-8200
(732) 974-0190
Mailing address
2130 HIGHWAY 35, BLDG C STE 312, SEA GIRT, NJ 08750-1010
(732) 974-8200
(732) 974-0190
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00282000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MD00282000
LICENSE
NJ
01
—
D08685300
CDS
NJ
Enumeration date
03/09/2006
Last updated
03/07/2023
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