Clark, Edward C

Clark, Edward C is an individual health care provider with primary practice located at 311 W 24Th St Suite 402, Erie PA 16502-2665. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Clark, Edward C can be contacted via phone (814) 453-6687.

Contact Information

Primary practice address
311 W 24Th St Suite 402 Erie PA 16502-2665
Phone: (814) 453-6687
Fax: (814) 456-4676
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X MD055901L Pennsylvania

Profile Details

NPI number 1013917814
LBN Legal business name Clark, Edward C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2005
Last updated Nov 13th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013917814 NPPES
Pennsylvania Other 776463 HIGHMARK PA BS
Pennsylvania MEDICAID 0015345390001 HIGHMARK PA BS
Pennsylvania Other 208292 HIGHMARK PA BS
Pennsylvania Other 390004949 HIGHMARK PA BS

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