Individual
MICHAEL THOMAS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-6200
Mailing address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
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
Primary
35.154087
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0370188
—
OH
Enumeration date
04/11/2019
Last updated
06/15/2026
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