Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Prof. Mariel Clark, PA, C

Individual provider Physician Assistant · NPI 1568475523

Prof. Mariel Clark, PA, C is a Physician Assistant in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2006.

Licensed in
PA
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

9501 Roosevelt Blvd Ste 410
Philadelphia, PA 19114-1025
Phone: (215) 969-4917
Fax: (215) 969-5875
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA000134L (PA)

Record details

NPI number1568475523
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA , C
Sole proprietorNo
NPI enumeratedAugust 14, 2006
Last updated in NPPESJuly 8, 2007

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