Individual
KOFI CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(717) 531-4950
(717) 531-6770
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD 060406 L
PA
207RG0100X
Gastroenterology Physician
Primary
MD060406L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001663170
—
PA
05
—
0016631700008
—
PA
01
—
109978
GEISINGER HEALTH PLAN
PA
01
—
110210402
RAILROAD MEDICARE
PA
01
—
111399
UNISON HEALTH PLAN
PA
01
—
12230
BRAVO HEALTH
PA
01
—
251879
UPMC HEALTH PLAN
PA
01
—
4175980-0001
CIGNA
PA
01
—
CL964338
HIGHMARK
PA
01
—
P001620
GATEWAY HEALTH PLAN
PA
Enumeration date
04/14/2006
Last updated
08/30/2016
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