Individual
MICHAEL E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4 SHERIDAN DRIVE, FAIRFIELD, ME 04937
(207) 861-5000
(207) 861-5001
Mailing address
4 SHERIDAN RD, FAIRFIELD, ME 04937-3314
(207) 861-5000
(207) 861-5001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
013687
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053387936
—
ME
05
—
272100099
—
ME
Enumeration date
02/28/2006
Last updated
10/16/2012
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