Individual
BRENT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9816 FRANKSTOWN RD, PITTSBURGH, PA 15235-1643
(412) 243-4525
(412) 243-3784
Mailing address
9816 FRANKSTOWN RD, PITTSBURGH, PA 15235-1643
(412) 243-4525
(412) 243-3784
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD042270L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012387920002
—
PA
05
—
0012387920005
—
PA
05
—
0012387920006
—
PA
01
—
1010600
GATEWAY HEALTH PLAN
PA
01
—
120315400
USDEPTOLABOR WORKERSCOMP
—
01
—
1203799
FIRST HEALTH
—
01
—
12627
ELDER HEALTH
—
01
—
250326
UPMC
PA
01
—
251661326
ADVANTRA
PA
01
—
3767
HEALTHAMERICA
—
01
—
47630
AETNA
PA
01
—
60049
UNISON ADVANTAGE
PA
01
—
617289
HIGHMARK
PA
01
—
64166
UNITEDMINEWORKERAMERICA
—
Enumeration date
03/10/2006
Last updated
08/01/2012
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