Clark, Matthew Thomas
Clark, Matthew Thomas is an individual health care provider with primary practice located at 200 Patewood Dr Ste A200 , Greenville SC 29615-3580. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatric Rheumatology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Rheumatology is his primary health care specialty. Clark, Matthew Thomas can be contacted via phone (864) 454-5004.Contact Information
Primary practice address
200 Patewood Dr Ste A200
Greenville SC 29615-3580
Phone: (864) 454-5004
Fax: (864) 241-9202
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
Allopathic & Osteopathic Physicians / Pediatric Rheumatology | 2080P0216X | 87391 | South Carolina |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 55984 | Tennessee |
Profile Details
NPI number | 1467872044 |
---|---|
LBN Legal business name | Clark, Matthew Thomas |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 22nd, 2014 |
Last updated | Sep 8th, 2022 - 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 | 1467872044 | NPPES |
South Carolina | MEDICAID | PENDING |
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