Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 30300 | NC |
NPI | 1164677415 |
---|---|
Provider Name | Dr. Karen Harrell Clark |
First Address | Chapel Hill, NC 27517-4426 |
Second Address | Chapel Hill, NC 27517-4426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2008 |
Last Update Date | 09/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C82998 | (02) | NC |