JAMES PAUL CLARK MD

Allergy and Immunology

Charleston, West Virginia

Provider NPI: 1306838453

Provider Information:
 JAMES PAUL CLARK MD


Practice Location:
3411A NOYES AVE SE  CHARLESTON, WV 25304 US
Tel: 304-344-2459  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	207KA0200X	Physicians Allergy & Immunology Allergy	WV	17504
Y	207K00000X	Physicians Allergy & Immunology	WV	17504

Other Provider Identifiers:

Issuer	Number	State	Type
AETNA	5720204	WV	01
BLUE CROSS BS	001722434	WV	01
	0079196000	WV	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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