Mary E Clark, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in White River Junction, Vermont. Her current practice location is
163 Veterans Drive, White River Junction, Vermont. You can reach out to her office (for appointments etc.) via phone at
(508) 776-8014.
Mary E Clark is licensed to practice in Massachusetts (license number 282335) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1104174846.
Physician's Profile
Full Name | Mary E Clark |
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Gender | Female |
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Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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Location | 163 Veterans Drive, White River Junction, Vermont |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104174846
- Provider Enumeration Date: 08/28/2012
- Last Update Date: 09/17/2021
Medicare PECOS Information:
- PECOS PAC ID: 5991137671
- Enrollment ID: I20191119000311
Medical Identifiers
Medical identifiers for Mary E Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104174846 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 27610 (Nebraska) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | LP05113 (Rhode Island) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 282335 (Massachusetts) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary E Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mary E Clark, MD 215 N Main St, White River Junction, VT 05009-0001 Ph: (508) 776-8014 | Mary E Clark, MD 163 Veterans Drive, White River Junction, VT 05009-4728 Ph: (508) 776-8014 |
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