Individual
DR. MICHAEL A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4643 WAIMEA CANYON DRIVE, WAIMEA, HI 96796
(808) 338-9431
Mailing address
PO BOX 1041, KOLOA, HI 96756-1041
(423) 202-8790
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
16124
HI
Other
Enumeration date
06/19/2007
Last updated
11/16/2012
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