Organization
M JUSTINE CLARK, DO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M JUSTINE CLARK DO (OWNER)
(410) 573-2292
Entity
Organization
Contact information
Practice address
600 RIDGELY AVE, SUITE 214, ANNAPOLIS, MD 21401
(410) 573-2292
Mailing address
600 RIDGELY AVE, SUITE 214, ANNAPOLIS, MD 21401
(410) 573-2292
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H41992
MD
Other
Enumeration date
11/29/2006
Last updated
08/22/2020
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