Individual
MICHAEL J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Mailing address
1720 HIGHWAY 59 S, THIEF RIVER FALLS, MN 56701-4331
(218) 681-4747
(218) 683-2595
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27254
MN
207Q00000X
Family Medicine Physician
5746
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2441653
AMERICA'S PPO/ARAZ #
FM
01
—
507S2CL
MNBS #
MN
05
—
564508500
—
MN
Enumeration date
07/03/2006
Last updated
03/25/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us