Individual
CHAD MICHAEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1155 MILL ST, RENO, NV 89502-1576
(775) 982-5000
(775) 982-3900
Mailing address
PO BOX 7055, RENO, NV 89510-7055
(704) 867-8021
(704) 864-4606
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25106
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1377R
BLUE CROSS BLUE SHIELD
—
01
—
3616084
AETNA HMO
—
01
—
560988142
UNITED HEALTHCARE
—
01
—
7095608
AETNA PPO
—
01
—
804966
PARTNERS
—
05
—
891377R
—
NC
01
—
D4989
MEDCOST
—
05
—
N0019C
—
SC
01
—
P00183056
RAILROAD MEDICARE
—
Enumeration date
12/06/2005
Last updated
04/14/2025
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