Individual
DR. WILLIAM BENNETT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 E MARSHALL ST, RICHMOND, VA 23298-5054
(804) 628-5054
Mailing address
12140 MORESTEAD CT, GLEN ALLEN, VA 23059-7071
(804) 240-2157
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
101247802
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116016320
VA
Other
Enumeration date
05/18/2007
Last updated
02/08/2013
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