GREGG P CLARK NPI 1053852608

NPI Information

NPI: 1053852608
Provider Name: GREGG P CLARK
Classification: Contractor - 171WH0202X
Entity Type: Individual

Specialization: Home Modifications

Address:
113 SMYRNA AVE
WILMINGTON, DE
ZIP 19809
Phone: (302) 218-1137
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Gregg P Clark is a home modifications contractor in Wilmington, DE. Gregg P Clark NPI is 1053852608. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

113 SMYRNA AVE
WILMINGTON, DE
ZIP 19809-234
Phone: (302) 218-1137

The enumeration date for this NPI number is 3/15/2017 and was last updated on 3/15/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171WH0202X	Contractor	Home Modifications	1990063352	DELAWARE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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