NPI 1245284629
Matthew William Clark, IDC
Practice location
- Address
- Uss Philippine Sea, Fpo, AA 34092-1178
- Phone
- (904) 270-6502
- Mailing address
- 453 Cody Dr, Orange Park, FL 32073-4214
Registered specialties
Independent Duty Corpsman
Primary
Registry record
- NPI
- 1245284629
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 20 May 2006
- Record last updated
- 12 May 2010
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.