Clark, Michael W
Clark, Michael W is an individual health care provider with primary practice located at 1234 Napier Ave , Saint Joseph MI 49085-2112. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Clark, Michael W can be contacted via phone (269) 983-8300.Contact Information
Primary practice address
1234 Napier Ave
Saint Joseph MI 49085-2112
Phone: (269) 983-8300
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 008264 | Michigan |
Profile Details
NPI number | 1073549804 |
---|---|
LBN Legal business name | Clark, Michael W |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 23rd, 2006 |
Last updated | Jan 28th, 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 | 1073549804 | NPPES |
Michigan | MEDICAID | 2580269 | |
Michigan | MEDICAID | 4742455 | |
Michigan | MEDICAID | 4742464 | |
Michigan | Other | MC008264 |
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