Individual
WESLEY MICHAEL CLARK PAUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-2200
Mailing address
100 HOSPITAL AVE, DU BOIS, PA 15801-1440
(814) 371-2200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301509321
MI
207Q00000X
Family Medicine Physician
4351046706
MI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
MT234993
PA
390200000X
Student in an Organized Health Care Education/Training Program
4351046706
MI
Other
Enumeration date
06/24/2020
Last updated
07/17/2025
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