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Individual

DR. WILLIAM ROBERT CLARKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000

Taxonomy

Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
278846
MA
207LP3000X
Pediatric Anesthesiology Physician
47307-020
WI
207LP3000X
Pediatric Anesthesiology Physician
MD00018770
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1699907485
WI
Enumeration date
08/13/2009
Last updated
05/28/2019
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