Individual
MR. TREVOR CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 PERKINS SQ, AKRON, OH 44308-1063
(330) 543-8823
(330) 296-6535
Mailing address
1 PERKINS SQ, AKRON, OH 44308-1063
(330) 543-8823
(330) 296-6535
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN284796
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000307293
ANTHEM PROVIDER
OH
05
—
2454286
—
OH
Enumeration date
05/20/2006
Last updated
08/10/2018
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