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General NPI Number Information
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NPI Number | 1396953428
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Entity Type | Individual
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Provider Name | DESHONDRA S CLARK PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | VETERANS AFFAIRS MEDICAL CTR 50 IRVING STREET, NW
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City | WASHINGTON
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State | DC
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Zip | 20422-0001
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Country | US
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Telephone | 202-745-8000
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Fax | 202-745-8639
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Provider Business Mailing Address
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Address Line | 2394 ANVIL LN
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City | TEMPLE HILLS
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State | MD
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Zip | 20748-4262
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Country | US
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Telephone | 301-505-4222
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | DC
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