Individual
ALLEN RICHARD CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
121 MEDICAL CENTER DR STE 2700, BRUNSWICK, ME 04011-2669
(207) 721-8700
(207) 536-6719
Mailing address
121 MEDICAL CENTER DR STE 2700, BRUNSWICK, ME 04011-2669
(207) 721-8700
(207) 536-6719
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01074111
IN
207V00000X
Obstetrics & Gynecology Physician
MD29198
ME
207VG0400X
Gynecology Physician
Primary
MD29198
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01074111A
LICENSE
IN
05
—
201233020
—
IN
Enumeration date
05/13/2010
Last updated
09/03/2025
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