Robert Dale Clark, M.D.
Individual provider Active NPI Family Medicine Physician · Newland, NC
NPI 1376542597 · NPPES record last updated Aug 20, 2018
Key facts
- NPI
- 1376542597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 0098-01210 (NC)
- Practice address
- 137 Notalee St
Newland, NC 28657 - Phone
- (828) 528-3009
- NPI assigned
- Jul 19, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0098-01210 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avery Wellness PLLC | Current |
Accepting new patients |
Locations
137 Notalee St
Newland, NC 28657
Phone (828) 397-9334
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0098-01210 | NC | Yes |
Addresses
Primary practice location
137 Notalee St
Newland, NC 28657
Mailing address
PO Box 58
Crossnore, NC 28616-0058
Phone (828) 528-1168
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89126GU | Medicaid | NC |
Other providers in Newland, NC
- Ansley Campbell
- Danielle Ryan Capparelli
- Carolina Integrative Psychological Services, PLLC
- Ashley Nicole Chapman
- Clark Family Medicine PA
- Shayna Vance Cole
- Compassionate Hearts Home Care Agency,Inc
- Betty Richelle Conley
- Ian Y.O. Cornwell
- County of Avery
All providers in Newland, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.