Individual
CHARLES AMOS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
VANDERBILT UNIVERSITY DEPT OF MEDICINE, D-3100, MEDICAL CENTER NORTH, NASHVILLE, TN 37232
(615) 322-0417
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 936-2000
(615) 936-0605
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
56206
TN
207RH0003X
Hematology & Oncology Physician
56206
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q031277
—
TN
Enumeration date
05/02/2014
Last updated
03/26/2022
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