Clark, Alysa Michelle

Clark, Alysa Michelle is an individual health care provider with primary practice located at 100 Michigan St Ne # Mc049 , Grand Rapids MI 49503-2560. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is her primary health care specialty. Clark, Alysa Michelle can be contacted via phone (616) 391-1680.

Contact Information

Primary practice address
100 Michigan St Ne # Mc049 Grand Rapids MI 49503-2560
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 4351045601 Michigan
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 207PP0204X 4301504949 Michigan

Profile Details

NPI number 1356903371
LBN Legal business name Clark, Alysa Michelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 29th, 2019
Last updated Apr 9th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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