Clark, Michael Dean

Clark, Michael Dean is an individual health care provider with primary practice located at 3805B Spring St , Racine WI 53405-1641. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Clark, Michael Dean can be contacted via phone (262) 687-4201.

Contact Information

Primary practice address
3805B Spring St Racine WI 53405-1641
Phone: (262) 687-4201
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 420-023 Wisconsin

Profile Details

NPI number 1033108014
LBN Legal business name Clark, Michael Dean
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated May 7th, 2013 - about 12 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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