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NPI Code Detail

MEDICARE: CAS OUTPATIENT DIVISION LLC

MEDICARE: CAS OUTPATIENT DIVISION LLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1477485548
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAS OUTPATIENT DIVISION LLC
Provider Business Mailing Address
First Line : 105 WATCH HARBOUR CT
Second Line :
City : SUFFOLK
State : VA
Zip : 23435-3179
Country : US
Telephone Number : 757-582-1629
Fax Number : 757-819-4995
Provider Business Practice Location Address
First Line : 1776 CAMBRIDGE DR
Second Line :
City : RICHMOND
State : VA
Zip : 23238-3203
Country : US
Telephone Number : 757-276-5022
Fax Number : 757-819-4995
Authorized Official
Title or Position : OWNER / CEO
Name : DR. VICTOR PIERRE CLARK
Credential : MD
Telephone Number : 757-582-1629
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “CAS OUTPATIENT DIVISION LLC ” Practice Location

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