MR. MICHAEL CLARK (NPI# 1942653688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942653688 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL CLARK |
| Credential | NP |
| Practice Address |
593 Eddy St Apc Suite 523 Providence RI 02903-4923 |
| Practice Telephone | 4014448467 |
| Mailing Telephone | 4014448467 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
APRN01380 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
| 1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
| 1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
| 1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
| 1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
| 1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
| 1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
| Street Address |
593 EDDY ST APC SUITE 523 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02903-4923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306185 | Mitchel A Sklar | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2005-06-15 |
| 1376140707 | Kristen Marie Czekanski | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-08 |
| 1326645300 | Elizabeth Stefanilo | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-03 |
| 1841807633 | Julie Walden | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-09-26 |
| 1417567751 | Yigit Baykara | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2020-08-02 |
| 1588273064 | Cassandra Pagnotta | Dietitian, Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-30 |
| 1982213294 | Sabitha Sasidharan Pillai | Pediatrics | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-23 |
| 1861019481 | Courtney Pedersen | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-30 |
| 1508483496 | Mohammad Hisham Hout | Urology | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-26 |
| 1639796642 | Benjamin Hagan | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475755 | Sarah Fellows | Student in an Organized Health Care Education/Training Program | 350 Eddy Street, Uri Nursing Education Center, Providence, RI 02903 | 2020-10-20 |
| 1093328262 | Esther Robbins | Social Worker | 290 West Exchange St., Suite 100, Providence, RI 02903 | 2020-08-27 |
| 1720619489 | Ivy Marie Mcdonald | Behavioral Analyst | 290 W Exchange St #101, Providence, RI 02903 | 2020-01-31 |
| 1447802707 | Natalie Monaghan, LLC | Social Worker | 545 South Water Street, Providence, RI 02903 | 2019-07-16 |
| 1760049522 | Daniel Steven Alanko | Pediatrics | 293 Eddy Street, Providence, RI 02903 | 2019-05-28 |
| 1154894368 | Margaret Emily Dyson | Behavior Technician | 290 W. Exchange St, Providence, RI 02903 | 2019-01-10 |
| 1497235014 | Yao Zhou Liu | Surgery | 593 Eddy St - Rhode Island Hospital, Providence, RI 02903 | 2018-08-14 |
| 1558840645 | Tamara Gore | Behavior Technician | 290 W Exchange Street Suite 101, Providence, RI 02903 | 2018-08-09 |
| 1437642709 | Adrian Cotarelo | Student in an Organized Health Care Education/Training Program | 174 Wickenden St, Apt. 3rd Floor, Providence, RI 02903 | 2018-06-12 |
| 1356833024 | Natalie Rita Noonan | Clinical Neuropsychologist | 593 Eddy St Ste 430, Providence, RI 02903 | 2018-05-30 |
| Find all providers in zip 02903 | ||||
| Taxonomy Code | 363LC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326645300 | Elizabeth Stefanilo | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-03 |
| City | PROVIDENCE |
| Zip Code | 02903 |
Please comment or provide details below to improve the information on MR. MICHAEL CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.