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Individual
DR. MATTHEW THOMAS CLARK
Active
Individual
DR. MATTHEW THOMAS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
55984
TN
2080P0216X
Pediatric Rheumatology Physician
Primary
87391
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
04/22/2014
Last updated
09/08/2022
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