Individual
MR. DONALD GODFREY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
29521 FORD RD, GARDEN CITY, MI 48135
(734) 367-1205
(734) 367-1214
Mailing address
29521 FORD RD, GARDEN CITY, MI 48135-2319
(734) 367-1205
(734) 367-1214
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5601001802
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601001802
STATE LICENSE
MI
Enumeration date
07/12/2006
Last updated
04/04/2024
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