Clark, Chad Michael

Clark, Chad Michael is an individual health care provider with primary practice located at 620 Summit Crossing Pl Ste 106, Gastonia NC 28054-2176. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Clark, Chad Michael can be contacted via phone (704) 867-8021.

Contact Information

Primary practice address
620 Summit Crossing Pl Ste 106 Gastonia NC 28054-2176
Phone: (704) 867-8021
Fax: (704) 864-4606
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X 200400199 North Carolina
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 2004-00199 North Carolina

Profile Details

NPI number 1275517831
LBN Legal business name Clark, Chad Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Apr 19th, 2024 - about 2 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 1275517831 NPPES
Other 1377R BLUE CROSS BLUE SHIELD
MEDICAID N0019C BLUE CROSS BLUE SHIELD
Other 7095608 BLUE CROSS BLUE SHIELD
MEDICAID 891377R BLUE CROSS BLUE SHIELD
Other P00183056 BLUE CROSS BLUE SHIELD
Other 804966 BLUE CROSS BLUE SHIELD
Other D4989 BLUE CROSS BLUE SHIELD
Other 3616084 BLUE CROSS BLUE SHIELD
Other 560988142 BLUE CROSS BLUE SHIELD

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