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Individual

SETH CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
200 CORLISS ST, PROVIDENCE, RI 02904
(401) 606-8530
(401) 606-8549
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD15837
RI
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
MD15837
RI

Other

Enumeration date
05/27/2014
Last updated
06/24/2025
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