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NPI Code Detail

MEDICARE: DR. STEVEN REED CLARKE DDS

MEDICARE: DR. STEVEN REED CLARKE DDS
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
11223G0001XGeneral Practice Dentistry0401006378VA

General Provider Information

NPI Number : 1184628620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN REED CLARKE DDS
Provider Business Mailing Address
First Line : 2520 HARRIS CREEK CT
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-6819
Country : US
Telephone Number : 757-471-1948
Fax Number :
Provider Business Practice Location Address
First Line : 2520 HARRIS CREEK CT
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23456-6819
Country : US
Telephone Number : 757-471-1948
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 10/19/2011

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Directions to “ DR. STEVEN REED CLARKE DDS” Practice Location

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