Individual
TIMOTHY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
521 S 7TH ST, APT 502, MINNEAPOLIS, MN 55415-1620
(613) 501-3552
Mailing address
521 S 7TH ST, APT 502, MINNEAPOLIS, MN 55415-1620
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/23/2015
Last updated
06/23/2015
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