NPI 1609912427 · live from the CMS NPI Registry
Charles Edward Clark, MD
Family Medicine in Bristol, VT. National Provider Identifier 1609912427, active.
NPI record
| NPI | 1609912427 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 74 Munsill Ave, Suite 100, Bristol, VT 05443 |
| Practice phone | 802-453-5028 |
| Enumerated | January 29, 2007 |
| Last updated | September 26, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | 0420006979 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.