DR. DAVID CHARLES CLARK JR. (NPI# 1720079767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720079767 |
| Entity Type | Individual |
| Full Name | DR. DAVID CHARLES CLARK JR. |
| Credential | MD |
| Practice Address |
1331 North Elm Street Suite 200 Greensboro NC 27401-6304 |
| Practice Telephone | 3362749614 |
| Practice Fax Number | 3364822177 |
| Mailing Telephone | 3362749614 |
| Mailing Fax Number | 3364822177 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2014-03-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
39405 | NC | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
39405 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | PARTNERS | 18290 | 01 |
| NC | UNITED HEALTHCARE | 1600796 | 01 |
| VA | VIRGINIA MEDICAID | 1720079767 | 01 |
| NC | 8922555 | 05 | |
| NC | MEDCOST | 70507 | 01 |
| NC | BLUE CROSS BLUE SHIELD | 22555 | 01 |
| NC | RAILROAD MEDICARE | 300050409 | 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 |
1331 NORTH ELM STREET SUITE 200 |
| City | GREENSBORO |
| State | NC |
| Zip Code | 27401-6304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275532798 | Adam Ryan Henn | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2005-07-18 |
| 1568624146 | Drew Edward Davis | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2008-06-25 |
| 1093973273 | Kelly Ann Brozzetti-cronin | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2008-05-25 |
| 1508031253 | Allen Thomas Grady | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2008-04-24 |
| 1851509723 | John Stewart Edmunds | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2007-05-21 |
| 1427265537 | Hetal Patel | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2007-05-17 |
| 1871517839 | Darrell Kevin Allred | Physician Assistant | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2006-07-26 |
| 1336168996 | Kevin F Bruning | Physician Assistant | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2006-07-18 |
| 1942239645 | Daniel William Entrikin | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2006-07-03 |
| 1265469795 | Diagnostic Radiology & Imaging, LLC | Radiology | 1331 North Elm Street, Suite 200, Greensboro, NC 27401-6304 | 2006-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779655 | Warfair Counseling, Consulting, & Supervision, Pllc | Counselor | 301 South Elm Street, Suite 801, Greensboro, NC 27401 | 2020-10-28 |
| 1225636848 | Alma Lucero Diaz | Registered Nurse | 1121 North Church St, Greensboro, NC 27401 | 2020-10-15 |
| 1447865217 | Rebecca Levy | Marriage & Family Therapist | Cone Health Family Medicine 1125 N Church Street, Greensboro, NC 27401 | 2020-09-09 |
| 1346854304 | Rayna's Home Care, LLC | Registered Nurse | 823 North Elm Street, Greensboro, NC 27401 | 2020-09-06 |
| 1316574718 | Garrett Green | Physician Assistant | 1121 N Church St., Greensboro, NC 27401 | 2020-03-25 |
| 1629635685 | Lauren Robinson Byrd | Anesthesiology | 1200 North Church St, Greensboro, NC 27401 | 2019-05-24 |
| 1285103069 | Shannon Marie Childs Meyerhoff | Occupational Therapist | Guilford County Schools Ec, 134 Franklin Blvd, Greensboro, NC 27401 | 2018-11-21 |
| 1194293241 | Ashley Marie Smith | Nurse Practitioner | 1200 North Elm St, Greensboro, NC 27401 | 2018-11-07 |
| 1285117762 | Anastazia Juszczak Gray | Speech-Language Pathologist | 1131 N. Church St, Greensboro, NC 27401 | 2018-09-11 |
| 1619474012 | Jamie Hannah Rose Aldridge | Psychiatry & Neurology | 1121 N Church Street, Greensboro, NC 27401 | 2018-04-11 |
| Find all providers in zip 27401 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| 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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245859453 | Triad Breast Imaging Center, LLC | Radiology | 3515 W Market St Ste 320, Greensboro, NC 27403-4438 | 2020-04-09 |
| 1073756177 | Total Radiology Solutions P A | Radiology | 5 Dovercrest Ct, Greensboro, NC 27407-8314 | 2009-04-20 |
| 1851568489 | Benjamin William Mcclintock | Radiology | 1331 N. Elm Street, Ste. 200, Greensboro, NC 27401-6304 | 2008-05-13 |
| 1336359199 | Melanie Bernadette Sanford | Radiology | 1331n Elm St 200, Greensboro, NC 27401-6304 | 2007-05-23 |
| 1992736326 | Diagnostic Radiology & Imaging, LLC | Radiology | 315 W Wendover Ave, Greensboro, NC 27408-8401 | 2006-07-05 |
| 1225077829 | Kyle D Talbot | Radiology | 1331 N. Elm St, Suite 200, Greensboro, NC 27401-6304 | 2006-06-06 |
| 1366497521 | John Arthur Strong | Radiology | 1317 N. Elm Street, Suite 1 B, Greensboro, NC 27401-1023 | 2006-05-24 |
| 1790743078 | Triad Imaging LLC | Radiology | 2705 Henry St, Greensboro, NC 27405-3669 | 2006-05-03 |
| 1538132162 | Geoffrey T Lamke | Radiology | 14 Canvasback Pt, Greensboro, NC 27455-1327 | 2006-02-13 |
| 1679551725 | William Walter Woodruff IIi | Radiology | 1331 N. Elm St., Ste. 200, Greensboro, NC 27401-6304 | 2006-01-08 |
| Find all providers in GREENSBORO | ||||
| City | GREENSBORO |
| Zip Code | 27401 |
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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.