Individual
MICHAEL DEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3805B SPRING ST, RACINE, WI 53405-1641
(262) 687-4201
Mailing address
2629 FOX RIVER PKWY, WAUKESHA, WI 53189-7876
(262) 521-1674
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
420-023
WI
Other
Enumeration date
10/21/2005
Last updated
04/19/2026
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