| Clark Alliance Services Inc | |
|
105 Watch Harbour Ct Suffolk VA 23435-3179 | |
| (757) 276-5020 | |
| (757) 819-4995 |
| Full Name | Clark Alliance Services Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 105 Watch Harbour Ct, Suffolk, Virginia |
| Authorized Official Name and Position | Victor Pierre Clark (CEO) |
| Authorized Official Contact | 7575821629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Alliance Services Inc 3575 Bridge Road, Suite 8 Po Box 611 Suffolk VA 23435 Ph: (757) 582-1629 | Clark Alliance Services Inc 105 Watch Harbour Ct Suffolk VA 23435-3179 Ph: (757) 276-5020 |
| NPI Number | 1952892028 |
|---|---|
| Provider Enumeration Date | 05/24/2018 |
| Last Update Date | 01/31/2020 |
| Medicare PECOS PAC ID | 8325475981 |
|---|---|
| Medicare Enrollment ID | O20200221000372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952892028 | NPI | - | NPPES |
| 1821251943 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nzinga Z Teule Hekima |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851399901 PECOS PAC ID: 4587608013 Enrollment ID: I20050615001013 |
| Provider Name | Michele A Irons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366402141 PECOS PAC ID: 0345246682 Enrollment ID: I20061010000761 |
| Provider Name | Naga S Chigurupati |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043298805 PECOS PAC ID: 9234109653 Enrollment ID: I20070117000502 |
| Provider Name | Kabaye Berhanu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386701753 PECOS PAC ID: 0244336006 Enrollment ID: I20080414000084 |
| Provider Name | Huy Anthony Tran |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235316936 PECOS PAC ID: 0547331688 Enrollment ID: I20080618000272 |
| Provider Name | Vishwas Jitendrabahai Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174793335 PECOS PAC ID: 0143392803 Enrollment ID: I20080712000108 |
| Provider Name | Horace J Jackson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669407003 PECOS PAC ID: 1951478569 Enrollment ID: I20080924000202 |
| Provider Name | Kyong Un Chong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023225059 PECOS PAC ID: 6002975224 Enrollment ID: I20081103000592 |
| Provider Name | Emily Eleanor Schley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154589299 PECOS PAC ID: 6406993534 Enrollment ID: I20091022000345 |
| Provider Name | Edward S Wong |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1760421473 PECOS PAC ID: 0244377372 Enrollment ID: I20091022000425 |
| Provider Name | Rahel T Amare |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982618211 PECOS PAC ID: 8325134653 Enrollment ID: I20091210000137 |
| Provider Name | Victor Clark |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821251943 PECOS PAC ID: 3577688381 Enrollment ID: I20100916001315 |
| Provider Name | Robert C Cajes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073776027 PECOS PAC ID: 2264619212 Enrollment ID: I20110531000756 |
| Provider Name | Vanitha S Sivakumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649433699 PECOS PAC ID: 9335318294 Enrollment ID: I20110810000076 |
| Provider Name | Sean M Kuczma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538457221 PECOS PAC ID: 1153643887 Enrollment ID: I20141208000133 |
| Provider Name | Vikas Pathak |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740474121 PECOS PAC ID: 8628262631 Enrollment ID: I20150207000037 |
| Provider Name | Jerry A Mcquain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770677254 PECOS PAC ID: 4688894272 Enrollment ID: I20150810002442 |
| Provider Name | Heather Anaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992239289 PECOS PAC ID: 2264709161 Enrollment ID: I20170524002912 |
| Provider Name | Habtamu D Giduma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316235906 PECOS PAC ID: 8123240058 Enrollment ID: I20170922001455 |
| Provider Name | Demetria L Yarbrough |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134375488 PECOS PAC ID: 8123171485 Enrollment ID: I20190408002105 |
| Provider Name | Tasneem Yousif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699235267 PECOS PAC ID: 4981082450 Enrollment ID: I20220613001266 |
| Provider Name | Yahya Azzam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588151617 PECOS PAC ID: 9537548987 Enrollment ID: I20220615002500 |
| Provider Name | Laura Brownson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174301048 PECOS PAC ID: 3870947260 Enrollment ID: I20231004001532 |
| Provider Name | Ashley Andersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477331320 PECOS PAC ID: 9537512041 Enrollment ID: I20240131005072 |
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