Individual
DR. MITCHELL BRENT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 CEDAR ST., YALE MEDICAL SCHOOL, NEW HAVEN, CT 06510
(203) 833-0281
Mailing address
333 CEDAR ST., YALE MEDICAL SCHOOL, NEW HAVEN, CT 06510
Taxonomy
Speciality
Code
Description
License number
State
207VX0201X
Gynecologic Oncology Physician
Primary
65152
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2013
Last updated
04/09/2020
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