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General NPI Number Information
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NPI Number | 1174813919
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Entity Type | Individual
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Provider Name | ALEXANDRA CLARK M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | UNIVERSITY DRIVE
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City | PITTSBURGH
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State | PA
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Zip | 15240
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Country | US
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Telephone | 412-360-1428
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Fax | 412-360-6588
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Provider Business Mailing Address
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Address Line | 2633 S 18TH STREET EXT APT 1
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City | PITTSBURGH
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State | PA
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Zip | 15210-1710
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Country | US
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Telephone | 540-840-0867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD457473
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License Number State | PA
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