Individual
DR. TAVIA DENISE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2015-02140
NC
208000000X
Pediatrics Physician
264842
MA
208000000X
Pediatrics Physician
MD174941
OR
208000000X
Pediatrics Physician
MD455243
PA
208000000X
Pediatrics Physician
MD60584128
WA
Other
Enumeration date
03/29/2012
Last updated
08/23/2023
Update your record
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