Clark, Melanie Anne

Clark, Melanie Anne is an individual health care provider with primary practice located at 10000 W Bluemound Rd , Wauwatosa WI 53226-4321. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Clark, Melanie Anne can be contacted via phone (414) 454-8000.

Contact Information

Primary practice address
10000 W Bluemound Rd Wauwatosa WI 53226-4321
Phone: (414) 454-8000
Fax: (414) 805-3808
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 125061558 Illinois
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 67202 Wisconsin

Profile Details

NPI number 1033464185
LBN Legal business name Clark, Melanie Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2012
Last updated Jul 26th, 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 1033464185 NPPES
Wisconsin MEDICAID 1033464185

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