Bryan D Clark (NPI# 1194742643, PAC ID# 0648258129) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1194742643 |
| PAC ID by PECOS | 0648258129 |
| Professional Enrollment ID | I20040712000090 |
| Full Name | Bryan D Clark |
| Organization Legal Name | INGLESIDE EMERGENCY GROUP LLC |
| Address |
1 Arh Ln Low Moor VA 24457 |
| Phone Number | 5408626011 |
| Gender | M |
| Credential | MD |
| Graduation Year | 2001 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 1355698317 |
| Number of Group Practice Members | 15 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 490126 | LEWISGALE HOSPITAL ALLEGHANY |
| 490116 | LEWISGALE HOSPITAL PULASKI |
| Address | Phone | Organization |
|---|---|---|
| 1 Arh Ln, Low Moor, VA 24457 | 5408626011 | INGLESIDE EMERGENCY GROUP LLC |
| 2400 Lee Hwy N, Pulaski, VA 24301-2326 | 5409948100 | KINGSFORD EMERGENCY GROUP, LLC |
| Organization Legal Name | INGLESIDE EMERGENCY GROUP LLC |
| Physicians | 14 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ankur S Fadia | Internal Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| John Stadnyk | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Paras K Pandya | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Electra C Martin | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Karl Herbert Kletzing | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Michele H Hollis | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Walid M Hammad | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Christopher David Smith | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Saqib M Shah | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Gregory Lynn Spears | Internal Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Street Address |
1 ARH LN |
| City | LOW MOOR |
| State | VA |
| Zip | 24457 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victoria Lorraine Nester | Certified Registered Nurse Anesthetist (crna) | Alleghany Anesthesia Associates | 1 Arh Ln, Low Moor, VA 24457 |
| Ankur S Fadia | Internal Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Colin A Rose | Diagnostic Radiology | Valley Imaging Consultants Inc. | 1 Arh Ln, Suite 100, Low Moor, VA 24457 |
| John Stadnyk | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Farid Dakermandji | Anesthesiology | Alleghany Anesthesia Associates | 1 Arh Ln, Low Moor, VA 24457 |
| Paras K Pandya | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Robert Henderson | Family Medicine | 1 Arh Ln, Suite 800, Low Moor, VA 24457 | |
| Amanda Rizk | Certified Registered Nurse Anesthetist (crna) | Alleghany Anesthesia Associates | 1 Arh Ln, Low Moor, VA 24457 |
| Electra C Martin | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Karl Herbert Kletzing | Emergency Medicine | Ingleside Emergency Group LLC | 1 Arh Ln, Low Moor, VA 24457 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacob M Mathew | Cardiovascular Disease (cardiology) | Ingleside Physician Services, LLC | 1 Arh Lane, Low Moor, VA 24457 |
| Brett Siebenkittel | Physical Therapy | Ridgeline Physical Therapy Inc | 2901 Selma Low Moor Rd, Low Moor, VA 24457 |
| Paul Lee Strausbaugh | Otolaryngology | Alleghany Ear, Nose and Throat PC | I-64 and St Rt, Suite 696, Low Moor, VA 24457 |
| Joe Marshall Pack | Osteopathic Manipulative Medicine | Wvva Health Care Alliance PC | 200 Arh Ln, Suite 102, Low Moor, VA 24457 |
| Adetokunbo A Ladenika | Psychiatry | Lewis Gale Physicians LLC | 1 Arc Lane, Low Moor, VA 24457 |
| Stephen Demma | Nurse Practitioner | Ingleside Physician Services, LLC | 1 Arc Lane, Low Moor, VA 24457 |
| Zeleke D Kassahun | Internal Medicine | Ingleside Physician Services, LLC | 1 Arc Lane, Low Moor, VA 24457 |
| Beth A Zierler | Physical Therapy | Ridgeline Physical Therapy Inc | 2901 Selma Low Moor Rd, Low Moor, VA 24457 |
| Jennifer Simpson | Occupational Therapy | Ridgeline Physical Therapy Inc | 2901 Selma Low Moor Rd, Low Moor, VA 24457 |
| Everett Kirk Luder | Psychiatry | Lewis Gale Physicians LLC | 1 Arc Lane, Low Moor, VA 24457 |
| Find all physicians in zip 24457 | |||
| City | LOW MOOR |
| Zip Code | 24457 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | LOW MOOR + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Bryan D Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.