Individual
DR. MELANIE ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
125061558
IL
207N00000X
Dermatology Physician
67202
WI
207N00000X
Dermatology Physician
67202-20
WI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
67202-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033464185
—
WI
Enumeration date
07/16/2012
Last updated
07/10/2026
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