Clark, Michael B
Clark, Michael B is an individual health care provider with primary practice located at 2002 Medical Pkwy Ste 235, Annapolis MD 21401-3046. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Clark, Michael B can be contacted via phone (410) 266-2770.Contact Information
Primary practice address
2002 Medical Pkwy Ste 235
Annapolis MD 21401-3046
Phone: (410) 266-2770
Fax: (410) 841-6251
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | D0056183 | Maryland |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | D0056183 | Maryland |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 35.080358 | Ohio |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD416976 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 200000198 | North Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 28302 | South Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME94700 | Florida |
Profile Details
| NPI number | 1538115423 |
|---|---|
| LBN Legal business name | Clark, Michael B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Feb 27th, 2009 - about 15 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 | 1538115423 | NPPES |
| Maryland | Other | N899 | AAD AA COUNTY |
| Maryland | Other | 019419A80 | AAD AA COUNTY |
| Maryland | Other | 2622593 | AAD AA COUNTY |
| Maryland | MEDICAID | 017000300 | AAD AA COUNTY |
| Maryland | Other | 8317071 | AAD AA COUNTY |
| Maryland | Other | 10690029 | AAD AA COUNTY |
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