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NPI Code Detail

MEDICARE: CHERYL ANN CLARK M.D.

MEDICARE: CHERYL ANN 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
12084P0800XPsychiatry Physician27073CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447250675
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL ANN CLARK M.D.
Provider Business Mailing Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-6675
Fax Number : 303-782-0916
Provider Business Practice Location Address
First Line : 4141 E DICKENSON PL
Second Line :
City : DENVER
State : CO
Zip : 80222-6012
Country : US
Telephone Number : 303-504-6675
Fax Number : 303-782-0916
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 02/01/2011

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