Provider Demographics
NPI:1306004452
Name:CLARKE-PEARSON, EMILY M (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:M
Last Name:CLARKE-PEARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 S WOLFE ST APT 243
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-3639
Mailing Address - Country:US
Mailing Address - Phone:401-829-7759
Mailing Address - Fax:
Practice Address - Street 1:915 S WOLFE ST APT 243
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-3639
Practice Address - Country:US
Practice Address - Phone:410-656-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-01398208200000X
MDD0078806208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery