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Individual

DR. MATTHEW JOHN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3801 SPRING ST, MOUNT PLEASANT, WI 53405-1667
(262) 687-4493
Mailing address
10625 W NORTH AVE STE 101B, WAUWATOSA, WI 53226-2315
(414) 877-5350

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
60882
TN
207P00000X
Emergency Medicine Physician
Primary
64936-20
WI

Other

Enumeration date
04/03/2014
Last updated
08/05/2024
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