Individual
MR. MICHAEL DAVID CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1121 W MICHIGAN ST, INDIANAPOLIS, IN 46202-5211
(772) 696-3555
(317) 274-5502
Mailing address
5107 COMMONWEALTH AVE, WESTERN SPRINGS, IL 60558-1716
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IN
Other
Enumeration date
02/24/2026
Last updated
02/24/2026
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