Individual
DR. SUSANNAH TAYLOR CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, DHMC DEPARTMENT OF GENERAL INTERNAL MEDICINE, LEBANON, NH 03756-1000
(603) 650-5000
Mailing address
1 MEDICAL CENTER DR, DHMC - DEPARTMENT OF GENERAL INTERNAL MEDICINE, LEBANON, NH 03756-1000
(603) 650-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12781
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011886
—
VT
05
—
30205694
—
NH
Enumeration date
08/14/2006
Last updated
11/04/2014
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