Individual
HOLLY MICHELLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
410 UNIVERSITY PARKWAY, SUITE 2300, AIKEN, SC 29801-6807
(803) 335-1219
(803) 335-1689
Mailing address
410 UNIVERSITY PARKWAY, SUITE 2300, AIKEN, SC 29801-6807
(803) 335-1219
(803) 335-1689
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
33738
SC
2084P0015X
Psychosomatic Medicine Physician
RTP001859
GA
2084P0800X
Psychiatry Physician
Primary
317493
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
337380
—
SC
Enumeration date
05/08/2007
Last updated
06/16/2022
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