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General NPI Number Information
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NPI Number | 1891759817
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Entity Type | Individual
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Provider Name | DANIEL H CLARKE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 04/18/2012
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Provider Practice Location Address
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Address Line | 2121 MEDICAL PARK DR SUITE 4
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City | SILVER SPRING
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State | MD
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Zip | 20902-4054
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Country | US
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Telephone | 301-681-4422
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Fax | 301-681-1684
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Provider Business Mailing Address
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Address Line | PO BOX 418837
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City | BOSTON
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State | MA
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Zip | 02241-8837
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Country | US
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Telephone | 888-846-5527
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Fax | 607-324-2369
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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 | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | D0063803
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 0101046018
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License Number State | VA
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