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Individual

DR. CRAIG B CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1301 PENN AVENUE, SUITE 100, DES MOINES, IA 50316-2364
(515) 263-2400
(515) 263-2540
Mailing address
1301 PENN AVE, SUITE 100, DES MOINES, IA 50316-2350
(515) 263-2400
(515) 263-2540

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
03037
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1240796
IA
05
1780666594
IA
Enumeration date
11/17/2005
Last updated
08/09/2012
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