MEDICARE: DR. CRYSTAL T CLARK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	AF2664200	MD

General Provider Information

NPI Number	:	1124159066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRYSTAL T CLARK M.D.

Provider Business Mailing Address
First Line	:	1020 PARK AVE
Second Line	:	APARTMENT 613
City	:	BALTIMORE
State	:	MD
Zip	:	21201-5640
Country	:	US
Telephone Number	:	708-574-1772
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 NORTH WOLFE STREET
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21287-7381
Country	:	US
Telephone Number	:	443-287-4506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1316262249 — ALEXANDRA R. STOLBERG M.D.
Practice Location Address:

600 N. WOLFE STREET , OFFICE MEYER 4-181
BALTIMORE, MD
21287-7381

Practice Phone: 410-955-8056
Practice Fax:

1255692216 — YE TAO MD
Practice Location Address:

600 N WOLFE ST , MEYER 3-181
BALTIMORE, MD
21287-7381

Practice Phone: 443-287-4506
Practice Fax:

1154988152 — ZOE I LUSCHER MD
Practice Location Address:

600 N. WOLFE STREET , MEYER 4-181
BALTIMORE, MD
21287-7381

Practice Phone: 443-287-4506
Practice Fax: 410-955-0152

1407960032 — STEVEN ALLEN BLACKWELL PH.D., J.D., R.PH.
Practice Location Address:

7500 SECURITY BLVD # C3-20-17 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244-1849

Practice Phone: 410-786-6852
Practice Fax:

1396961561 — DR. MARSHA SMITH MD
Practice Location Address:

7500 SECURITY BOULEVARD , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21201-2301

Practice Phone: 410-786-6614
Practice Fax:

1134335441 — JULIE DAWN PREIS
Practice Location Address:

7500 SECURITY BLVD MS C1-13-07 , CENTERS FOR MEDICARE & MEDICAID SERVICES
BALTIMORE, MD
21244

Practice Phone: 410-786-0525
Practice Fax:

Directions to “ DR. CRYSTAL T CLARK M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.