Individual
GWENDOLYN ELIZABETH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7710 MERCY ROAD SUITE 202, OMAHA, NE 68124
(720) 382-9349
Mailing address
7710 MERCY ROAD SUITE 202, OMAHA, NE 68124
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9645
NE
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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