Organization
CLARK MEDICAL SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOUNIR Y ABDELSHAHID (M.D.)
(862) 213-0033
Entity
Organization
Contact information
Practice address
135 BLOOMFIELD AVE STE F, BLOOMFIELD, NJ 07003-5902
(862) 213-0033
Mailing address
135 BLOOMFIELD AVE STE F, BLOOMFIELD, NJ 07003-5902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0343757
—
NJ
Enumeration date
08/12/2016
Last updated
08/12/2016
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