DR. SUSAN CHRISTINE CLARK (NPI# 1104096650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104096650 |
| Entity Type | Individual |
| Full Name | DR. SUSAN CHRISTINE CLARK |
| Credential | MD |
| Practice Address |
517 Moye Blvd Fl 1 Ecu Physicians Surgery - Moye Medical Center #2 Greenville NC 27834-2849 |
| Mailing Address |
Po Box 751069 Ecu Physicians Charlotte NC 28275-1069 |
| Practice Telephone | 2527442393 |
| Practice Fax Number | 2527440018 |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2011-10-24 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 2011-00718 | NC | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | MD426779 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBSNC | 163WH | 01 |
| NC | 5918139 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161950 | Susan Marie Clark | Nurse Practitioner | 674 Coral Way, Winter Springs, FL 32708-3127 | 2020-07-09 |
| 1528591575 | Susan Clark | Counselor | 604 S Walnut, Stillwater, OK 74074-4222 | 2017-04-06 |
| 1790178556 | Susan March Clark | Peer Specialist | 3277 E 2nd St, Tulsa, OK 74104-2134 | 2015-03-17 |
| 1841537990 | Susan Noble Clark | Developmental Therapist | 1730 Radcliffe Rd, Montgomery, AL 36106-2620 | 2013-01-09 |
| 1881963411 | Susan Clark | Occupational Therapy Assistant | 38 Wheeler Ave, Warwick, NY 10990-1341 | 2011-12-28 |
| 1437302684 | Susan Maslin Clark | Chiropractor | 20416 Bowfonds St, Ashburn, VA 20147-7457 | 2008-11-01 |
| 1871780940 | Susan Marie Clark | Counselor | 112 S Water St Ste B, Kent, OH 44240-3689 | 2007-10-02 |
| 1750403861 | Susan M Clark | Psychologist | 1022 Cherokee Ave, Royal Oak, MI 48067 | 2007-04-06 |
| 1598892085 | Susan L Clark | Psychiatry & Neurology | 9515 60th Ave W, Mukilteo, WA 98275 | 2007-02-28 |
| 1609968692 | Susan M Clark | Pediatrics | 1318 S Main Road, Vineland, NJ 08360 | 2006-09-28 |
| Street Address |
517 MOYE BLVD FL 1 ECU PHYSICIANS SURGERY - MOYE MEDICAL CENTER #2 |
| City | GREENVILLE |
| State | NC |
| Zip Code | 27834-2849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669464475 | Carl E Haisch | Surgery | 517 Moye Blvd Fl 1, Ecu Physicians Transplant Surgery, Greenville, NC 27834-2849 | 2005-08-17 |
| 1174878169 | Rebecca Ann Scarborough | Dietitian, Registered | 517 Moye Blvd Fl 1, Ecu Physicians Surgery, Greenville, NC 27834-2849 | 2012-07-17 |
| 1427115823 | Dustin Miguel Bermudez | Surgery | 517 Moye Blvd Fl 1, Ecu Physicians Surgery, Moye Medical Center #2, Greenville, NC 27834-2849 | 2007-01-03 |
| 1881678654 | Richard F Williams | Surgery | 517 Moye Blvd Fl 1, Ecu Physicians General Surgery, Greenville, NC 27834-2849 | 2005-12-05 |
| 1467435503 | Eric A Toschlog | Surgery | 517 Moye Blvd Fl 1, Ecu Physicians Critical Care Surgery, Greenville, NC 27834-2849 | 2005-11-22 |
| 1255326898 | Walter J Pories | Surgery | 517 Moye Blvd Fl 1, Ecu Physicians General Surgery, Greenville, NC 27834-2849 | 2005-09-20 |
| 1952396814 | Walter E Pofahl II | Surgery | 517 Moye Blvd Fl 1, Ecu Physicians General Surgery, Greenville, NC 27834-2849 | 2005-09-16 |
| 1326030123 | Claudia E Goettler | Surgery | 517 Moye Blvd Fl 1, Ecu Physicians Trauma & Critical Care, Greenville, NC 27834-2849 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801255 | Nicholas Mcarthur Bennett | Day Training, Developmentally Disabled Services | 302 C, Greenville, NC 27834 | 2020-08-11 |
| 1275150245 | Shelby Renee Jones | Student in an Organized Health Care Education/Training Program | East Carolina University College of Nursing, 600 Moye Blvd, Greenville, NC 27834 | 2020-06-25 |
| 1194347138 | Soban Ahmad | Student in an Organized Health Care Education/Training Program | 600 Moye Blvd., Vmc Ma Room 350. Internal Medicine Resi, Mailstop #734, Greenville, NC 27834 | 2020-05-13 |
| 1427687789 | Brandon Allen Yates | Student in an Organized Health Care Education/Training Program | 435 Clinic Drive, Greenville, NC 27834 | 2020-04-07 |
| 1144854407 | Kristen Springer Dreyfus | Marriage & Family Therapist | 2609 West Arlington Blvd Suite 106, Greenville, NC 27834 | 2020-02-26 |
| 1861038606 | Southern Surgical Outpatient Surgery Center, Pa | Clinic/Center | 2457 Emerald Place, Greenville, NC 27834 | 2019-11-26 |
| 1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
| 1649831496 | Katherine Salome Ross | Genetic Counselor, MS | 524 Moye Blvd, Greenville, NC 27834 | 2019-06-24 |
| 1477011880 | Lauren Bethune Scroggs | Counselor | 2150 West 5th Street, Health Sciences Building Mailstop 688, Greenville, NC 27834 | 2019-03-05 |
| 1669998001 | Idella's Care Home | Community/Behavioral Health | 2912 Lee Ct # 9a, Greenville, NC 27834 | 2017-08-17 |
| Find all providers in zip 27834 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790213833 | Judson Chase Woollen | Surgery | 701 Grove Rd Fl 3, Greenville, SC 29605-4210 | 2017-06-02 |
| 1962792580 | Jessica Gonzalez Hernandez | Surgery | Carolina Surgical Associates Eastside, 135 Commonwealth Drive Ste 210, Greenville, SC 29615-4850 | 2011-04-15 |
| 1730406067 | Pablo Gabriel Giuseppucci | Surgery | 115 Woodshire Rd, Greenville, PA 16125-1215 | 2010-04-27 |
| 1831345081 | Bindhu Oommen | Surgery | 4215 Joe Ramsey Blvd E Ste 220, Greenville, TX 75401-7852 | 2008-08-07 |
| 1538377833 | David Joseph Skarupa | Surgery | 600 Moye Blvd, 2ed, Ecu Brody School of Medicine Dept of Surgery, Greenville, NC 27834 | 2007-05-18 |
| 1639385354 | Patricia Lynn Eichhorn | Surgery | 2104 Woodruff Road, Greenville, SC 29607 | 2007-05-16 |
| 1275690232 | I. H. Shah, M.d. and S. Hasan, M.d. and Associates | Surgery | 4004 Medical Parkway, Greenville, TX 75401 | 2007-01-02 |
| 1245316439 | Donald R Gilbert | Surgery | 2106 Woodruff Rd, Greenville, SC 29607 | 2006-10-31 |
| 1619059334 | John C Mobley | Surgery | 404 Wagner Ave, Greenville, OH 45331-2537 | 2006-10-20 |
| 1184712101 | Norman F. Mcgowin IIi | Surgery | 45 Medical Arts Ct Ste 4, Greenville, AL 36037-3872 | 2006-10-11 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 27834 |
Please comment or provide details below to improve the information on DR. SUSAN CHRISTINE CLARK.
| 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.