DR. DAVID A CLARK (NPI# 1396793949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396793949 |
| Entity Type | Individual |
| Full Name | DR. DAVID A CLARK |
| Credential | MD |
| Practice Address |
4600 Lake Boone Trail Suite 100 Raleigh NC 27607-7529 |
| Practice Telephone | 9197871374 |
| Practice Fax Number | 9197889007 |
| Mailing Telephone | 9197871374 |
| Mailing Fax Number | 9197889007 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2012-09-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 35295 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | RAILROAD MEDICARE | 040010474 | 01 |
| NC | 8922601 | 05 | |
| NC | UNITED HEALTHCARE | 1050087 | 01 |
| NC | BLUE CROSS | 22601 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225388531 | David Clark | Pharmacist | 87 Garner Rd., Cvs 4174, Spartanburg, SC 29303 | 2012-09-13 |
| 1568778793 | David F Clark | Social Worker | 4425 S Jones Blvd, Suite D3, Las Vegas, NV 89103-3370 | 2010-08-25 |
| 1407093065 | David E. Clark | Dietitian, Registered | 4132 Sierra Park Ter, Dayton, OH 45440-3324 | 2009-01-19 |
| 1962668202 | David Allen Clark | Dentist | 4209 Tieton Dr, Suite 102, Yakima, WA 98908-3377 | 2008-08-06 |
| 1548427693 | David Kyle Clark | Dentist | 2120 Bert Kouns Loop Ste D, Shreveport, LA 71118-3351 | 2008-05-16 |
| 1790957603 | David C. Clark | Pharmacist | 1215 Route 31, Macedon, NY 14502-9763 | 2008-03-31 |
| 1275722365 | David Allan Clark | Counselor | 50196 872nd Rd, Page, NE 68766-5539 | 2007-10-15 |
| 1649488214 | David D Clark | Chiropractor | 2573 N Reading Rd, Denver, PA 17517-9333 | 2007-05-18 |
| 1306059480 | David Roger Clark | Ophthalmology | 2812 Millbrook Ct, Arlington, TX 76012-2116 | 2007-05-07 |
| 1619049327 | David B Clark | Chiropractor | 106 Se 12th St, Oak Grove, MO 64075-9538 | 2006-11-15 |
| Street Address |
4600 LAKE BOONE TRAIL SUITE 100 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27607-7529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477554327 | Capitol Ear, Nose & Throat | Audiologist | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2005-08-02 |
| 1043489834 | Melanie Corgill-cox | Speech-Language Pathologist | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2008-02-26 |
| 1740459569 | Emily Catherine Burt | Audiologist-Hearing Aid Fitter | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2008-02-26 |
| 1790983344 | Kristin A Bryant | Audiologist | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2007-07-05 |
| 1487603700 | Mark S Brown | Otolaryngology | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2006-05-06 |
| 1003874231 | Harvey Craig Price | Otolaryngology | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2006-05-04 |
| 1295783199 | Stanley A Wilkins | Otolaryngology | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2006-05-04 |
| 1437107430 | Steven H Dennis | Otolaryngology | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2006-05-04 |
| 1376501049 | Russell Glen Medders | Otolaryngology | 4600 Lake Boone Trail, Suite 100, Raleigh, NC 27607-7529 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972093144 | Kyndra Lawson | Behavior Technician | 5121 Kingdom Way, Suite 100, Raleigh, NC 27607 | 2018-05-14 |
| 1578082905 | Margaret Roberts Bova | Dietitian, Registered | 4207 Lake Boone Trail, Suite 210, Raleigh, NC 27607 | 2017-09-18 |
| 1184141897 | Chricat Garrard | Nurse Practitioner | 4207 Lake Boone Trl Ste 200, Raleigh, NC 27607 | 2017-08-23 |
| 1487178620 | John Patrick Morton | Pharmacist | 2411 Landmark Dr, Raleigh, NC 27607 | 2017-07-31 |
| 1023538857 | Heather Margaret Mazzola | Audiologist | 7800 Lake Boone Trail, 100, Raleigh, NC 27607 | 2017-06-22 |
| 1790216984 | North Carolina Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2411 Landmark Drive, Raleigh, NC 27607 | 2017-03-21 |
| 1558819516 | Corilin Nocito Meggitt | Nurse Practitioner | 4505 Fair Meadows Ln Ste 102, Raleigh, NC 27607 | 2016-09-19 |
| 1942757034 | Stacie Walker | Obstetrics & Gynecology | 4414 Lake Boone Trl Ste 311, Raleigh, NC 27607 | 2016-09-06 |
| 1831644533 | Alisa Smajlagic Howe | Nurse Practitioner | 4210 Lake Boone Trail, Rex Rehab & Nursing Center, Raleigh, NC 27607 | 2016-08-23 |
| 1235598632 | Yoseph Saleh | Dentist | 107 Minden Ln, Raleigh, NC 27607 | 2016-02-15 |
| Find all providers in zip 27607 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710320510 | Nicolas-george Katsantonis | Otolaryngology | 4600 Lake Boone Trl Ste 100, Raleigh, NC 27607 | 2013-04-10 |
| 1346595238 | Bethany Lisi Buie | Otolaryngology | 3024 New Bern Ave Ste 200, Raleigh, NC 27610-1247 | 2012-07-17 |
| 1528390697 | Fred F. Holt | Otolaryngology | 4928 Misty Oak Dr, Raleigh, NC 27613-6348 | 2010-02-01 |
| 1699972307 | Jeevan B Ramakrishnan | Otolaryngology | 4600 Lake Boone Trl, Suite 100, Raleigh, NC 27607-7501 | 2007-06-27 |
| 1205971934 | Robert Powell Majors Jr. | Otolaryngology | 3508 Williamsborough Ct, Raleigh, NC 27609-6354 | 2007-02-20 |
| 1558370734 | Brett Edward Dorfman | Otolaryngology | 11200 Governor Manly Way Ste 110, Raleigh, NC 27614-7360 | 2006-08-05 |
| 1124043823 | Henry Clifford Baggett | Otolaryngology | 2518 Wake Dr, Raleigh, NC 27608-1340 | 2006-07-13 |
| 1730112442 | Barbara A Burggraaff | Otolaryngology | 5603 Duraleigh Rd Ste B, Raleigh, NC 27612-2688 | 2006-07-08 |
| 1194769752 | Timothy James Heffron | Otolaryngology | 10880 Durant Rd Ste 124, Raleigh, NC 27614-6629 | 2006-06-15 |
| 1043250822 | Magda El Raheb Pugh | Otolaryngology | 10010 Falls of Neuse Suite 012, Raleigh, NC 27614 | 2006-06-08 |
| Find all providers in RALEIGH | ||||
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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.