IndividualActive
Charles Clark, MD
NPI 1124301106 · Endocrinology, Diabetes & Metabolism Physician · Indianapolis, IN
Provider details
- NPI number
- 1124301106
- Entity type
- Individual
- Primary specialty
- Endocrinology, Diabetes & Metabolism PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 01020086A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2802 Lafayette Road Suite 13
Eagledale Health Center
Indianapolis, IN 46222-2112
Phone: (317) 923-7510
Fax: (317) 923-7518
Approximate (ZIP-level) locationGet directions
Mailing address
2802 Lafayette Road Suite 13
Indianapolis, IN 46222-2112
Registry dates
- Enumerated
- 2011-09-26
- Last updated
- 2011-09-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.