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Individual

DR. MICHAEL BRADY CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1400 MCKEAN RD, SPRING HOUSE, PA 19477
(215) 793-7131
Mailing address
1400 MCKEAN RD, PO BOX 776, SPRING HOUSE, PA 19477
(215) 793-7131

Taxonomy

Speciality
Code
Description
License number
State
2083A0100X
Aerospace Medicine Physician
Primary
0101056149
VA
2083A0100X
Aerospace Medicine Physician
055114
GA

Other

Enumeration date
02/24/2011
Last updated
06/04/2012
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