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Contact Information

MARY E CLARK, MD
163 VETERANS DRIVE
WHITE RIVER JUNCTION, VT05009-4728
 Phone: 508-776-8014
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anatomic Pathology & Clinical Pathology

207ZP0102X 22 Physician/Pathology
Indicates primary specialty

NPI Profile & details for MARY E CLARK · (Female)

NPI Number 1104174846
Status Active
Credentials MD
Entity Individual
Enumeration date 08/28/2012
Last updated 09/17/2021 - About 5 years ago
Sole proprietor 1 Yes
Identifiers
  • MA License # 282335
  • NE License # 27610
  • RI License # LP05113
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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