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:
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Health care specialties

SpecialtyCodeLicense #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 14 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 1528028925 NPPES
Georgia MEDICAID 00239368K

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