Provider Demographics
NPI:1780666966
Name:CLEMENT, MARK E (OD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:CLEMENT
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:104 MARUTH DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3926
Mailing Address - Country:US
Mailing Address - Phone:412-736-7716
Mailing Address - Fax:
Practice Address - Street 1:461 COCHRAN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1253
Practice Address - Country:US
Practice Address - Phone:412-341-1441
Practice Address - Fax:412-341-1184
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG-354152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA397168OtherNATIONAL VISION ADMIN.
PAU82201OtherHEALTH AMERICA
PA2521779OtherAETNA HMO
PA6621OtherDAVIS VISION
PA1342958OtherBLUE CROSS/BLUE SHIELD
PA220087OtherUPMC
PA243765701OtherUNITED HEALTHCARE
PACL913321OtherCLARITY VISION
PAPA355OtherVBA
PA7456187OtherAETNA PPO
PA243765701OtherUNITED HEALTHCARE
PAPA355OtherVBA