DR. EDWARD C CLARK (NPI# 1013917814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013917814 |
| Entity Type | Individual |
| Full Name | DR. EDWARD C CLARK |
| Credential | M.D. |
| Practice Address |
311 W 24th St Suite 402 Erie PA 16502-2665 |
| Practice Telephone | 8144536687 |
| Practice Fax Number | 8144564676 |
| Mailing Telephone | 8144536687 |
| Mailing Fax Number | 8144564676 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2009-11-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD055901L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | UPMC | 208292 | 01 |
| PA | MEDICARE PALMETTO | 390004949 | 01 |
| PA | HIGHMARK PA BS | 776463 | 01 |
| PA | 0015345390001 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043570732 | Edward Clark | Counselor | 4015 Nine Mcfarland Dr, Suite #175, Alpharetta, GA 30004-8493 | 2012-05-29 |
| 1093028870 | Edward Derby Clark I | Counselor | 1355 Pebblewood Dr, Sacramento, CA 95833-1612 | 2010-07-21 |
| 1053474080 | Edward Joseph Clark IIi | Radiology | 1705 S. Tarboro St, Wilson, NC 27893 | 2006-12-19 |
| 1730294232 | Edward Deallen Clark | Obstetrics & Gynecology | 1600 W College St Ste Ll10, Grapevine, TX 76051-3598 | 2006-08-21 |
| 1205843604 | Edward Mark Clark | Dentist | 5211 Yellowstone Rd, Ste # 1, Cheyenne, WY 82009-4761 | 2006-08-01 |
| 1528074523 | Edward Lee Clark | Dentist | 2727 Sw 17th Pl, Redmond, OR 97756-1297 | 2006-07-31 |
| 1124028311 | Edward C Clark | Ophthalmology | 11355 Pembrooke Sq, Suite 107, Waldorf, MD 20603-4805 | 2005-07-28 |
| 1063072429 | Edward Clark | Technician | 1310 6th St Nw, Washington, DC 20001-3495 | 2019-06-18 |
| 1710490800 | Edward E Clark Jr. | Registered Nurse | 10 Penfield Ave, Akron, OH 44310-2912 | 2017-11-10 |
| 1033638424 | Edward Clark | Licensed Practical Nurse | 6600 E Ben White Blvd, Austin, TX 78741-7537 | 2017-09-17 |
| Street Address |
311 W 24TH ST SUITE 402 |
| City | ERIE |
| State | PA |
| Zip Code | 16502-2665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003477407 | Mary Katherine Lasher | Family Medicine | 311 W 24th St, Erie, PA 16502-2665 | 2019-06-26 |
| 1154857274 | Joseph Michael Krissel | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-05-10 |
| 1245764182 | Muhammad Samad Khan | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-04-18 |
| 1396279600 | Jessica Lerman | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-04-13 |
| 1497289821 | Joseph Datsko | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2017-04-12 |
| 1093257487 | Saint Vincent Medical Education and Research Inst. Inc | Podiatrist | 311 W 24th St, Suite 303, Erie, PA 16502-2665 | 2016-11-16 |
| 1447609847 | Tad Antognini | Family Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2016-06-07 |
| 1689022253 | Albert Tang | Family Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2016-05-24 |
| 1316391543 | Adam Fredrick Christensen | Emergency Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2016-04-13 |
| 1720442098 | Amanda Marie Wincik | Family Medicine | 311 W 24th St, 4th Floor, Erie, PA 16502-2665 | 2016-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679064794 | Fernando Torres | Specialist/Technologist | 549 1/2 W 7th St, Erie, PA 16502 | 2018-05-24 |
| 1548782907 | Michael Wayne Hankins Jr. | Podiatrist | 5515 Peach Street, Erie, PA 16502 | 2017-07-07 |
| 1730609041 | Michael Greg Palmer | Family Medicine | 311 West 24th Street 4th Floor, Erie, PA 16502 | 2017-06-27 |
| 1245658723 | Amy Adamus | Licensed Practical Nurse | 1647 Sassafras Street, Erie, PA 16502 | 2014-04-02 |
| 1295011088 | Margaret Gay Wardd | Licensed Practical Nurse | 1757 West 23 Street, Erie, PA 16502 | 2011-10-25 |
| 1659510782 | Kristen Kathleen Curry | Social Worker | 329 W. 10th St., Erie, PA 16502 | 2009-02-12 |
| 1699928416 | Kelly Cathleen Kelly-zazado | Social Worker | 301 W. 10th St., Lake Erie Counseling, Inc, Erie, PA 16502 | 2008-10-23 |
| 1922149350 | Wei-lung Sam Wu | Internal Medicine | Saint Vincent Professional Building, 311 West 24 Street, Suite 402, Erie, PA 16502 | 2007-02-09 |
| 1003970146 | Claire Donch | Psychologist | 301 West 10th Street, Erie, PA 16502 | 2006-12-21 |
| 1730703117 | Vincent Viet Ngo | Family Medicine | 311 West 24th Street, 4th Floor, Erie, PA 16502 | 2020-06-02 |
| Find all providers in zip 16502 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922149350 | Wei-lung Sam Wu | Internal Medicine | Saint Vincent Professional Building, 311 West 24 Street, Suite 402, Erie, PA 16502 | 2007-02-09 |
| 1730355256 | Muhammad Ahsan Baig | Internal Medicine | 311 W 24th St, Suite 402, Erie, PA 16502-2667 | 2008-05-05 |
| 1306873914 | Asim Ranjan Singh | Internal Medicine | 350 E Bayfront Pkwy, Unit C, Erie, PA 16507-2410 | 2006-06-27 |
| 1194761643 | Bayview Nephrology, Inc. | Internal Medicine | 350 E Bayfront Pkwy, Unit C, Erie, PA 16507-2410 | 2006-06-22 |
| 1548205669 | Rekha Dinker Halligan | Internal Medicine | 350 E Bayfront Pkwy, Unit C, Erie, PA 16507-2410 | 2006-06-20 |
| 1356386817 | Alexander Kosenko | Internal Medicine | 350 E Bayfront Pkwy, Unit C, Erie, PA 16507-2410 | 2006-06-18 |
| 1548203813 | Peter Paul Barzyk IIi | Internal Medicine | 350 E Bayfront Pkwy, Unit C, Erie, PA 16507-2410 | 2006-06-14 |
| 1568419448 | Associates In Nephrology PC | Internal Medicine | 311 W 24th St, Suite 402, Erie, PA 16502-2665 | 2006-05-27 |
| 1417958083 | Darren E Dreyfus | Internal Medicine | 311 W 24th St, Suite 402, Erie, PA 16502-2665 | 2005-08-09 |
| 1205835741 | Francis P Foti | Internal Medicine | 201 State St, Erie, PA 16550-0002 | 2005-07-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.