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Adele Clark, PA
Medical Physician Assistant in Winston Salem, North Carolina
NPI 1841228335

Adele Clark is a Medical Physician Assistant based in Winston-Salem, NC and is specialized in Medical. Adele Clark practices in Winston Salem, NC and has the professional credentials of PA. The NPI Number for Adele Clark is 1841228335 and holds a License No. 100690 (North Carolina).

The current practice location address for Adele Clark is 4618 Country Club Rd, Winston Salem, NC and can be reached out via phone at 336-716-2255 and via fax at 336-716-9258.

Location: 4618 Country Club Rd, Winston Salem, NC, 27102-0344
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Provider Profile Details
NPI Number
1841228335
Provider Name
Adele Clark
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
4618 Country Club Rd, Winston Salem, NC, 27102-0344
Phone Number
336-716-2255
Fax Number
336-716-9258
Provider Enumeration Date
06/30/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
189348 01 NC MEDCOST
7825786 01 NC AETNA
institution
Provider Business Practice Location Address Details
Address
4618 Country Club Rd
City
State
Zip
27104-3520
Phone Number
336-716-2255
Fax Number
336-716-9258
person
Provider Business Mailing Address Details
Address
4618 Country Club Rd
City
State
Zip
27104-3520
Phone Number
336-716-2255
Fax Number
336-716-9258
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
100690 (North Carolina)
Definition
Definition to come...
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