Clark, Melanie Anne
Clark, Melanie Anne is an individual health care provider with primary practice located at 10000 W Bluemound Rd , Wauwatosa WI 53226-4321. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Clark, Melanie Anne can be contacted via phone (414) 454-8000.Contact Information
Primary practice address
10000 W Bluemound Rd
Wauwatosa WI 53226-4321
Phone: (414) 454-8000
Fax: (414) 805-3808
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 125061558 | Illinois |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 67202 | Wisconsin |
Profile Details
| NPI number | 1033464185 |
|---|---|
| LBN Legal business name | Clark, Melanie Anne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 16th, 2012 |
| Last updated | Jul 26th, 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 | 1033464185 | NPPES |
| Wisconsin | MEDICAID | 1033464185 |
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