Individual
DR. BRIAN JOSEPH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 CEDAR ST, TAC-441 SOUTH, NEW HAVEN, CT 06520-8057
(203) 785-4162
Mailing address
PO BOX 208057, NEW HAVEN, CT 06520-8057
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
53323
CT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
53323
CT
207RP1001X
Pulmonary Disease Physician
Primary
53323
CT
Other
Enumeration date
06/17/2010
Last updated
12/08/2022
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