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Contact Information

CAROLYN CLARK, MD
4461 STARKEY ROAD
SUITE 201
ROANOKE, VA24018
 Phone: 540-345-4946
 Fax: 540-343-7693
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CAROLYN CLARK · (Female)

NPI # 1033156617
Status Active
Credentials MD
Entity Individual
Enumeration date 06/01/2006
Last updated 04/05/2011 - About 15 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0101057337
  • VA Medicaid 1033156617
  • VA Other 5427630 AETNA
  • VA Other 393746 ANTHEM
  • VA Other 7236246 CIGNA
  • VA Other 110165956 RAILROAD MEDICARE
  • VA Other 294398 SOUTHERN HEALTH
Hospital affiliation(s)
  • CARILION ROANOKE MEMORIAL CENTER - (Acute Care)
    1906 BELLEVIEW AVENUE, SE
    ROANOKE, VA 24014
  • LEWISGALE MEDICAL CENTER - (Acute Care)
    1900 ELECTRIC ROAD
    SALEM, VA 24153
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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