Individual
ANDREW D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
160 PERPETUAL SQ, ANDERSON, SC 29621-1713
(864) 512-5880
(864) 375-1347
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-5880
(864) 375-1347
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2010-01153
NC
207V00000X
Obstetrics & Gynecology Physician
Primary
29173
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112203A
—
GA
05
—
291730
—
SC
Enumeration date
07/25/2006
Last updated
01/05/2023
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