NPI 1790728459 · live from the CMS NPI Registry
David Glenn Clark, MD
Psychiatry & Neurology, Neurology in Indianapolis, IN. National Provider Identifier 1790728459, active.
NPI record
| NPI | 1790728459 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 1701 N Senate Blvd, Indianapolis, IN 46202 |
| Practice phone | 888-484-3258 |
| Mailing address | 250 N Shadeland Ave, Indianapolis, IN 46219 |
| Enumerated | June 13, 2006 |
| Last updated | March 8, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology | 2084N0400X | 21639 (AL) |
| Psychiatry & Neurology, Neurology | 2084N0400X | 37037 (SC) |
| Psychiatry & Neurology, Neurology primary | 2084N0400X | 01080891A (IN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.