David Glenn Clark, MD
Psychiatry & Neurology, Neurology in Indianapolis, IN. Individual provider (NPI-1).
NPI number1790728459
StatusActive
Last updated in NPPESMar 8, 2025
Details
- NPI
- 1790728459
- Entity type
- Individual (NPI-1)
- Name
- David Glenn Clark
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2006
- Certification date
- Mar 8, 2025
- Last updated
- Mar 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | 01080891A | IN | Yes |
| 2084N0400X | Psychiatry & Neurology, Neurology | 21639 | AL | |
| 2084N0400X | Psychiatry & Neurology, Neurology | 37037 | SC |
Practice location
1701 N Senate BlvdIndianapolis, IN 46202-1239
Phone 888-484-3258
Mailing address
250 N Shadeland AveIndianapolis, IN 46219-4959
Phone 877-668-5621
Other practice locations
171 Ashley Ave
Charleston, SC 29425-8908
Charleston, SC 29425-8908
Phone 843-792-1414
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