| Andrew Ryan Clark, MD | |
|
5300 Kidspeace Dr, Orefield, PA 18069-2044 | |
| (610) 799-8000 | |
| (610) 799-8801 |
| Full Name | Andrew Ryan Clark |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 5300 Kidspeace Dr, Orefield, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033200506 | NPI | - | NPPES |
| LL27954 | Other | SC | LICENSE |
| MD439197 | Other | PA | LICENSE |
| 058450 | Other | GA | LICENSE |
| 102671034-0001 | Medicaid | PA |
| Entity Name | St Lukes Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700984622 PECOS PAC ID: 6709798333 Enrollment ID: O20040226000062 |
| Entity Name | Penn Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073572715 PECOS PAC ID: 0446246011 Enrollment ID: O20040421000664 |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew Ryan Clark, MD 5300 Kidspeace Dr, Orefield, PA 18069-2044 Ph: (610) 799-8853 | Andrew Ryan Clark, MD 5300 Kidspeace Dr, Orefield, PA 18069-2044 Ph: (610) 799-8000 |
Dr. Ashleigh Anderson, DO Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 5300 Kidspeace Dr, Orefield, PA 18069 Phone: 610-799-8853 Fax: 610-799-8001 | |
Matthew S Koval, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 5300 Kidspeace Dr, Orefield, PA 18069 Phone: 800-854-3123 | |
Dr. Kutaiba S Chaleby, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 5300 Kidspeace Dr, Orefield, PA 18069 Phone: 610-799-8477 | |
Dr. Amy Garner, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 5300 Kidspeace Dr, Orefield, PA 18069 Phone: 800-854-3123 Fax: 610-799-8801 |