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NPI Code Detail

MEDICARE: CLAUDINE CLARKE MD

MEDICARE: CLAUDINE CLARKE MD
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
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianMD070074LPA

General Provider Information

NPI Number : 1699728774
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAUDINE CLARKE MD
Provider Business Mailing Address
First Line : 6950 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-2120
Country : US
Telephone Number : 215-512-1811
Fax Number :
Provider Business Practice Location Address
First Line : 6950 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-2120
Country : US
Telephone Number : 215-512-1811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 03/14/2016

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