Individual
RICHARD CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2041 GEORGIA AVE NW, WASHINGTON, DC 20060-0001
(202) 865-6711
(202) 865-6713
Mailing address
2024 GEORGIA AVE NW, WASHINGTON, DC 20001-3027
(202) 595-3223
(202) 332-2985
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD30288
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005719933
—
VA
05
—
026516400
—
DC
05
—
914510900
—
MD
Enumeration date
11/07/2006
Last updated
08/03/2007
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