Individual
MICHAEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
850 N MAIN STREET EXT, BLGD 2 SUITE C2, WALLINGFORD, CT 06492-2400
(203) 269-9778
(203) 949-1544
Mailing address
850 N MAIN STREET EXT, BLGD 2 SUITE C2, WALLINGFORD, CT 06492-2400
(203) 269-9778
(203) 949-1544
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41950
CT
Other
Enumeration date
06/23/2005
Last updated
07/31/2015
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