Individual
KRISTIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5018 DORSEY HALL DR, SUITE 104, ELLICOTT CITY, MD 21042-7855
(410) 730-8288
(888) 235-9533
Mailing address
5018 DORSEY HALL DR, SUITE 104, ELLICOTT CITY, MD 21042-7855
(410) 730-8288
(888) 235-9533
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0053966
MD
Other
Enumeration date
03/09/2006
Last updated
03/30/2012
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