Clark, Melissa

Clark, Melissa is an individual health care provider with primary practice located at 6545 France Ave S Suite 400, Edina MN 55435-2131. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Clark, Melissa can be contacted via phone (952) 920-9191.

Contact Information

Primary practice address
6545 France Ave S Suite 400 Edina MN 55435-2131
Phone: (952) 920-9191
Fax: (952) 920-0232
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 43490 Minnesota

Profile Details

NPI number 1700890688
LBN Legal business name Clark, Melissa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700890688 NPPES
Other 1202276 MEDICA
Other CP9021031726 MEDICA
Other 390S9CL MEDICA

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