| Doctor Name: | EDWARD JOSEPH CLARK |
| NPI Number: | 1053474080 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 1705 S. Tarboro St Wilson, NC - 27893 |
| Business Phone Number: | 2523998928 |
| Business Fax Number: | 2523997313 |
| Mailing Address: | Po Box 12156, NEWPORT NEWS |
| State: | VA |
| Postal Code: | 236122156 |
| Phone Number: | 7578676101 |
| Fax Number: | 7578676588 |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |