Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JENNIFER DIANE CLARK, MD
ActivePediatrics · MIDLOTHIAN, VA
Registration Details
- NPI Number
- 1871556878
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 10, 2006 (20.092944058969 yrs)
- Last Updated
- Jan 28, 2021
- Licenses
-
0101 056329 (VA)MD23961 (ME)
Practice Information
- Address
-
14732 VILLAGE SQUARE PLMIDLOTHIAN, VA, 231122253Browse VA providers · Browse ZIP 23112
- Phone
- 8046390717
- Fax
- 8046390767
- Primary Specialty
-
Pediatrics
208000000X
- Additional Specialty
- Pediatrics
Other Pediatrics Providers in MIDLOTHIAN, VA
| Name | Credential | NPI |
|---|---|---|
| DR. MARK A FLANZENBAUM | M.D. | 1134129398 |
| DR. JUDITH PRITIKIN GROSSBERG | MD | 1811970148 |
| DR. ELIZABETH MARIE CULLEN | MD | 1174506414 |
| DR. MARTHA REY SAUNDERS | MD | 1316922388 |
| DEBRA L CANTOR | MD | 1700855624 |
| ROXANA GABRIELLA BANTLE | MD | 1417906801 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.