Clark, Carol
Clark, Carol is an individual health care provider with primary practice located at 3601 W 13 Mile Rd Ec, Royal Oak MI 48073-6712. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Clark, Carol can be contacted via phone (248) 898-0575.Contact Information
Primary practice address
3601 W 13 Mile Rd Ec
Royal Oak MI 48073-6712
Phone: (248) 898-0575
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 4301050141 | Michigan |
Profile Details
| NPI number | 1215996574 |
|---|---|
| LBN Legal business name | Clark, Carol |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Jul 19th, 2022 - about 2 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 | 1215996574 | NPPES |
| Michigan | Other | 010F362410 | BCBSM |
| Michigan | MEDICAID | 2746544 | BCBSM |
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