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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073549804 NPPES
Michigan MEDICAID 2580269
Michigan MEDICAID 4742455
Michigan MEDICAID 4742464
Michigan Other MC008264

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