Organization Name: | DAMD, INC |
NPI Number: | 1013010198 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARY ELIZABETH BERNAL-CLARK (CRNP) |
Mailing Address: | 331 Buttercup Ct Berlin |
State: | MD US |
Postal Code: | 21811 |
Phone Number: | 4107132353 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2006 |
NPI Last Update Date: | 09/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | LG-0000410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | DE |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |