Clark, Michael Dean
Clark, Michael Dean is an individual health care provider with primary practice located at 5669 Peachtree Dunwoody Rd Ne Suite 100, Atlanta GA 30342-1786. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Clark, Michael Dean can be contacted via phone (404) 256-0404.Contact Information
Primary practice address
5669 Peachtree Dunwoody Rd Ne Suite 100
Atlanta GA 30342-1786
Phone: (404) 256-0404
Fax: (404) 847-0423
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 022527 | Georgia |
Profile Details
| NPI number | 1528028925 |
|---|---|
| LBN Legal business name | Clark, Michael Dean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2006 |
| Last updated | Aug 23rd, 2011 - about 13 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 | 1528028925 | NPPES |
| Georgia | MEDICAID | 00239368K |
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