Individual
DOMINIQUE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7474 GREENWAY CENTER DR STE 730, GREENBELT, MD 20770-3523
(301) 982-3437
(301) 982-9452
Mailing address
7474 GREENWAY CENTER DR, STE 700B, GREENBELT, MD 20770-3523
(240) 277-3359
(845) 231-6078
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0005875
MD
Other
Enumeration date
09/21/2015
Last updated
07/21/2022
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