Bradley Clark, M.D. Valid NPI

Individual provider · Emergency Medicine Physician · Inkom, ID

NPI

1124354964

Type

Individual (Type 1)

Primary specialty

Emergency Medicine Physician (Emergency Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207P00000X

License number

M-8299 (ID)

Sex

Male

Sole proprietor

Yes

Enumerated

2009-10-29

Last updated

2009-10-29