Clark, Brian M
Clark, Brian M is an sole proprietor health care provider with primary practice located at 22 West St Ste 25 , Millbury MA 01527-2677. He recently has only one registered license in Allopathic & Osteopathic Physicians / Reproductive Endocrinology, which is considered as his primary health care specialty. Clark, Brian M can be contacted via phone (508) 917-6720.Contact Information
Primary practice address
22 West St Ste 25
Millbury MA 01527-2677
Phone: (508) 917-6720
Fax: (508) 917-6721
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Reproductive Endocrinology | 207VE0102X | 226853 | Massachusetts |
Profile Details
| NPI number | 1437159795 |
|---|---|
| LBN Legal business name | Clark, Brian M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2005 |
| Last updated | Mar 1st, 2021 - about 3 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437159795 | NPPES |
| Massachusetts | MEDICAID | 2112191 |
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