| Clark Infectious Disease Group | |
|
2220 Edward Holland Dr Richmond VA 23230-2519 | |
| (757) 582-1629 | |
| (757) 819-4995 |
| Full Name | Clark Infectious Disease Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 2220 Edward Holland Dr, Richmond, Virginia |
| Authorized Official Name and Position | Victor P Clark (OWNER) |
| Authorized Official Contact | 7575821629 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Infectious Disease Group 105 Watch Harbour Ct Suffolk VA 23435-3179 Ph: (757) 582-1629 | Clark Infectious Disease Group 2220 Edward Holland Dr Richmond VA 23230-2519 Ph: (757) 582-1629 |
| NPI Number | 1477247864 |
|---|---|
| Provider Enumeration Date | 06/07/2023 |
| Last Update Date | 07/07/2023 |
| Medicare PECOS PAC ID | 7113380940 |
|---|---|
| Medicare Enrollment ID | O20230828001540 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477247864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Edward S Wong |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1760421473 PECOS PAC ID: 0244377372 Enrollment ID: I20091022000425 |
| Provider Name | Sana Attar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790172724 PECOS PAC ID: 7416208574 Enrollment ID: I20200917002787 |
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