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Individual

MICHAEL THOMAS CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-8906
Mailing address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 944-8906

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.154087
OH
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
35.154087
OH
2080P0202X
Pediatric Cardiology Physician
Primary
01088048A
IN
2080P0202X
Pediatric Cardiology Physician
35.154087
OH

Other

Enumeration date
04/11/2019
Last updated
04/27/2026
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