Clark, Matthew Thomas

Clark, Matthew Thomas is an individual health care provider with primary practice located at 200 Patewood Dr Ste A200 , Greenville SC 29615-3580. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatric Rheumatology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Rheumatology is his primary health care specialty. Clark, Matthew Thomas can be contacted via phone (864) 454-5004.

Contact Information

Primary practice address
200 Patewood Dr Ste A200 Greenville SC 29615-3580
Phone: (864) 454-5004
Fax: (864) 241-9202
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatric Rheumatology 2080P0216X 87391 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 55984 Tennessee

Profile Details

NPI number 1467872044
LBN Legal business name Clark, Matthew Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2014
Last updated Sep 8th, 2022 - about 4 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 1467872044 NPPES
South Carolina MEDICAID PENDING

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