Clark, Thomas
Clark, Thomas is an sole proprietor health care provider with primary practice located at 4924 Campbell Blvd , Baltimore MD 21236-5908. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Clark, Thomas can be contacted via phone (443) 442-2300.Contact Information
Primary practice address
4924 Campbell Blvd
Baltimore MD 21236-5908
Phone: (443) 442-2300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | C0000159 | Maryland |
Profile Details
| NPI number | 1932142056 |
|---|---|
| LBN Legal business name | Clark, Thomas |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2006 |
| Last updated | May 9th, 2013 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932142056 | NPPES |
| Maryland | Other | 970011935 | RAILROAD MEDICARE |
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