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NPI Code Detail

MEDICARE: ALEJANDRA CLARK M.D

MEDICARE:   ALEJANDRA  CLARK  M.D
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1821250358
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEJANDRA CLARK M.D
Provider Business Mailing Address
First Line : 231 ALBERT SABIN WAY
Second Line : ML 0558
City : CINCINNATI
State : OH
Zip : 45267-2827
Country : US
Telephone Number : 513-558-5190
Fax Number : 513-558-3477
Provider Business Practice Location Address
First Line : 231 ALBERT SABIN WAY
Second Line : ML 0558
City : CINCINNATI
State : OH
Zip : 45267-2827
Country : US
Telephone Number : 513-558-5190
Fax Number : 513-558-3477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2008
Last Update Date : 12/02/2021

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