Clark, Susan Christine
Clark, Susan Christine is an sole proprietor health care provider with primary practice located at Naval Medical Center Portsmouth 620 John Paul Jones Circle, Portsmouth VA 23708. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Clark, Susan Christine can be contacted via phone (757) 953-9759.Contact Information
Primary practice address
Naval Medical Center Portsmouth 620 John Paul Jones Circle
Portsmouth VA 23708
Phone: (757) 953-9759
Fax: (757) 953-0845
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 2011-00718 | North Carolina |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD426779 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 0101253279 | Virginia |
Profile Details
| NPI number | 1104096650 |
|---|---|
| LBN Legal business name | Clark, Susan Christine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 11th, 2008 |
| Last updated | Feb 20th, 2024 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104096650 | NPPES |
| North Carolina | MEDICAID | 5918139 | |
| North Carolina | Other | 163WH |
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