Individual
DR. CASEY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 767-4574
Mailing address
EMERGENCY PHYSICIANS, P.A., 4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
70463
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70463
MINNESOTA BOARD OF MEDICAL PRACTICE
MN
Enumeration date
04/17/2019
Last updated
07/12/2022
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