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General NPI Number Information
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NPI Number | 1932555430
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Entity Type | Individual
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Provider Name | MIRIAM FRANCES CLARKE DO
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Gender | Female
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Dates
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Enumeration Date | 05/13/2016
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Last Update Date | 06/22/2023
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Provider Practice Location Address
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Address Line | 807 FARSON ST STE 101
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City | BELPRE
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State | OH
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Zip | 45714-1000
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Country | US
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Telephone | 740-423-3611
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Fax | 740-423-3602
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Provider Business Mailing Address
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Address Line | 807 FARSON ST STE 101
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City | BELPRE
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State | OH
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Zip | 45714-1000
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2020-00718
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 34.015203
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License Number State | OH
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