Clark, Michael L

Clark, Michael L is an individual health care provider with primary practice located at 596 W Main St , Wilmington OH 45177-2123. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Clark, Michael L can be contacted via phone (937) 283-2588.

Contact Information

Primary practice address
596 W Main St Wilmington OH 45177-2123
Phone: (937) 283-2588
Fax: (937) 283-2594
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 35062520C Ohio

Profile Details

NPI number 1114988540
LBN Legal business name Clark, Michael L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated May 1st, 2023 - about 3 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 1114988540 NPPES
Ohio MEDICAID 0969420

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