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Individual

DR. ROBERT EARL CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PHD

Contact information

Practice address
200 WELLESLEY TRADE LN, CARY, NC 27519-5576
(919) 363-7546
(919) 363-3616
Mailing address
200 WELLESLEY TRADE LN, CARY, NC 27519-5576
(919) 363-7546
(919) 363-3616

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
31121
NC
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
31121
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0354066
UNITED HEALTHCARE
NC
01
070012681
RETIRED RAILROAD MEDICARE
NC
01
11591
BCBS
NC
01
13123
PARTNERS
NC
01
13334
DOCTOR'S HEALTH PLAN
NC
01
2046860
AETNA HMO
NC
01
259852
MAMSI
NC
01
4347967
AETNA PPO
NC
01
562070218C
CIGNA
NC
01
81690
MEDCOST
NC
05
8911591
NC
01
9715177001
CIGNA HEALTHCARE
NC
Enumeration date
06/27/2005
Last updated
09/29/2020
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