Individual
MAYA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13400 W OUTER DR, DETROIT, MI 48239-1309
(313) 592-5216
(313) 592-5012
Mailing address
13924 BURNING TREE LN, PLYMOUTH, MI 48170-2699
(734) 667-5282
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704173166
MI
Other
Enumeration date
01/31/2007
Last updated
07/08/2007
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