Individual
ELIZABETH ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
DEPT OF OB GYN MSC 10 5580, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131
(505) 272-4051
(505) 272-6385
Mailing address
DEPT OF OB GYN MSC 10 5580, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-4051
(505) 272-6385
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
079783
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
04/01/2014
Last updated
07/20/2018
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