HEATHER CLARK (NPI# 1972900520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972900520 |
| Entity Type | Individual |
| Full Name | HEATHER CLARK |
| Other Name | HEATHER STULTZ |
| Credential | PA-C |
| Practice Address |
9815 Main St Ste 208 Damascus MD 20872 |
| Mailing Address |
9815 Main St Ste 208 Damascus MD 20872-2099 |
| Practice Telephone | 3012534004 |
| Practice Fax Number | 3012533391 |
| Mailing Telephone | 3012534004 |
| Mailing Fax Number | 3012533391 |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2019-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | C0005635 | MD | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | C0005635 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1415 Mountain Road, Joppa, MD 21085 | 4109180777 | 4103691701 |
| 504 E Ridgeville Blvd, Mount Airy, MD 21771 | 3017035452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417387721 | Heather Summers Clark | Counselor | 12729 Nw Twin Oaks Dr, Bristol, FL 32321-3431 | 2013-11-22 |
| 1093095010 | Heather C Clark | Physical Therapist | 778 Baeder Rd, Jenkintown, PA 19046-2236 | 2011-08-22 |
| 1619184959 | Heather Clark | Day Training/Habilitation Specialist | 200 General St, Batesville, AR 72501-9407 | 2007-05-17 |
| 1033281555 | Heather E Clark | Dentist | 269 N Easton Rd, Glenside, PA 19038-4717 | 2006-11-14 |
| 1336139252 | Heather J Clark | Pharmacist | 14720 Metcalf Ave, Overland Park, KS 66223-2204 | 2005-10-22 |
| 1356343784 | Heather M Clark | Dentist | 2311 New Rd, Northfield, NJ 08225-1442 | 2005-08-15 |
| 1295365815 | Heather Elan Clark | Registered Nurse | 5721 Hamilton Rd, Jordan, NY 13080-9760 | 2020-01-23 |
| 1861983116 | Heather Nicole Clark | Counselor | 510 E Carolina Ave, Hartsville, SC 29550-4396 | 2018-05-22 |
| 1215424270 | Heather Lynn Clark | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave Box Med, Rochester, NY 14642-0001 | 2018-04-16 |
| 1467976696 | Heather Clark | Physician Assistant | 3200 E Racine St, Janesville, WI 53546-2343 | 2017-07-31 |
| Street Address |
9815 MAIN ST STE 208 |
| City | DAMASCUS |
| State | MD |
| Zip Code | 20872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972072601 | Jayesh N Patel | Pharmacist | Weis Pharmacy, 26075 S. Ridge Rd, Damascus, MD 20872 | 2018-11-26 |
| 1396264834 | Perfect Balance Counseling Services, LLC | Counselor | 28201 Clarksburg Road, Damascus, MD 20872 | 2017-09-15 |
| 1669819991 | Teicher Nicole Agosto | Pharmacist | 25613 Coltrane Drive, Damascus, MD 20872 | 2013-05-28 |
| 1295178663 | Cherifath Imelda Akimey Amadou Kiki | Home Health Aide | 2705 Nicholson Street Apt 302, Hyattsville, MD 20872 | 2013-04-16 |
| 1013297084 | Vera Bong Sangbong | Pharmacist | 9807 Main Street, Damascus, MD 20872 | 2011-08-23 |
| 1881736502 | Graciano P Gancayco | Pediatrics | 9701 New Church St., Damascus, MD 20872 | 2007-02-12 |
| 1700961893 | Richard J Schoeb Dds Chtd | Dentist | 9701 New Church St, Suite 9, Damascus, MD 20872 | 2006-10-26 |
| 1508838111 | Frank H Lewis Dds LLC | Dentist | 9899 Main St, Suite 200, Damascus, MD 20872 | 2006-02-07 |
| 1952303604 | Theresa D Poepperling | Midwife | 26005 Ridge Road, Suite 200, Damascus, MD 20872 | 2005-08-12 |
| 1801311360 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 9840 Main St, Damascus, MD 20872 | 2017-08-07 |
| Find all providers in zip 20872 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093123119 | Armando Jorge Jesse Guerrero | Physician Assistant | 20291 Coolgreen Rd, Damascus, VA 24236-4131 | 2014-08-01 |
| 1679577464 | Dennis Allen Rochester | Physician Assistant | 9815 Main St, Suite 208, Damascus, MD 20872-2002 | 2005-06-09 |
| 1720209646 | Lynda Packard | Physician Assistant | 26005 Ridge Rd, Suite 200, Damascus, MD 20872-1892 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659325 | Stephanie Liss | Physician Assistant | 1003 Willowleaf Way, Potomac, MD 20854-2937 | 2020-11-05 |
| 1306447495 | Naftali Zapinsky | Physician Assistant | 3507 Labyrinth Rd, Baltimore, MD 21215-1731 | 2020-11-04 |
| 1306447768 | Elizabeth Kolbe Schneider | Physician Assistant | 2205 Deadora Dr, Bel Air, MD 21015-8521 | 2020-11-03 |
| 1982204160 | Bich-hanh Le | Physician Assistant | 16328 Decker Pl, Derwood, MD 20855-2181 | 2020-10-28 |
| 1972102416 | Francesca Mertan | Physician Assistant | 829 Concorde Cir Apt 4402, Linthicum Heights, MD 21090-1780 | 2020-10-24 |
| 1235738683 | Ester Dahee Kim | Physician Assistant | 2400 W Belvedere Ave, Baltimore, MD 21215-5216 | 2020-10-17 |
| 1245838804 | Erin Washington | Physician Assistant | 2708 Tallowtree Rd, Woodstock, MD 21163-1462 | 2020-10-15 |
| 1669070991 | Niklavs Peteris Eglitis | Physician Assistant | 905 Paulsboro Dr, Rockville, MD 20850-3027 | 2020-10-09 |
| 1922605583 | Kurt William Moulton | Physician Assistant | Health Center At Ward and West 8000 York Rd, Towson, MD 21252-0001 | 2020-10-07 |
| 1215541404 | Aaron Mccauley | Physician Assistant | 3 Dunhaven Pl Apt 2d, Nottingham, MD 21236-3161 | 2020-09-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.