Clark, Rebecca
Clark, Rebecca is an individual health care provider with primary practice located at 660 Beaver Creek Cir Suite 100, Maumee OH 43537-1745. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Clark, Rebecca can be contacted via phone (419) 891-6221.Contact Information
Primary practice address
660 Beaver Creek Cir Suite 100
Maumee OH 43537-1745
Phone: (419) 891-6221
Fax: (419) 893-3394
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35080735 | Ohio |
Profile Details
| NPI number | 1033111752 |
|---|---|
| LBN Legal business name | Clark, Rebecca |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | Nov 3rd, 2023 - about last year |
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 | 1033111752 | NPPES |
| Ohio | Other | 04219 | PARAMOUNT |
| Ohio | Other | 000000246226 | PARAMOUNT |
| Ohio | Other | 7534411 | PARAMOUNT |
| Ohio | Other | 12-04381 | PARAMOUNT |
| Ohio | MEDICAID | 2333264 | PARAMOUNT |
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