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Contact Information

RYAN R CLARK, PA-C
181 LAKE EDEN RD
BLACK MOUNTAIN, NC28711-8707
 Phone: 704-770-5527
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for RYAN R CLARK · (Male)

NPI # 1376283218
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 03/30/2022
Last updated 03/30/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers Not Available
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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