Mark Clark (NPI# 1407958291, PAC ID# 7719022615) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1407958291 |
| PAC ID by PECOS | 7719022615 |
| Professional Enrollment ID | I20100303000560 |
| Full Name | Mark Clark |
| Organization Legal Name | GENESYS INTEGRATED GROUP PRACTICE PC |
| Address |
7477 S State Rd Goodrich MI 48438-8745 |
| Phone Number | 8106362235 |
| Gender | M |
| Medical School | UNIVERSITY OF MICHIGAN MEDICAL SCHOOL |
| Graduation Year | 1981 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 7810809357 |
| Number of Group Practice Members | 122 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230197 | GENESYS REGIONAL MEDICAL CENTER - HEALTH PARK |
| Address | Phone | Organization |
|---|---|---|
| 3495 S Ctr Rd, Burton, MI 48519-1455 | 8104242025 | GENESYS INTEGRATED GROUP PRACTICE PC |
| 7477 S State Rd, Goodrich, MI 48438-8745 | 8106362235 | GENESYS INTEGRATED GROUP PRACTICE PC |
| Organization Legal Name | GENESYS INTEGRATED GROUP PRACTICE PC |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nancy J Kursik | Family Practice | Genesys Integrated Group Practice PC | 3495 S Ctr Rd, Burton, MI 48519-1455 |
| Jagdish K Shah | Internal Medicine | Genesys Integrated Group Practice PC | 307 E Court St, Flint, MI 48502-1611 |
| Edna R Bick | Family Practice | Genesys Integrated Group Practice PC | 8477 Davison Rd, Davison, MI 48423-2114 |
| Stacy L Welsh | Nurse Practitioner | Genesys Integrated Group Practice PC | 1096 S Belsay Rd C, Burton, MI 48509-1948 |
| Samuel A Gill | Physical Therapy | Genesys Integrated Group Practice PC | 2222 S Linden Rd B, Physicians Integrated Physical Therapy, Flint, MI 48532-5413 |
| Matthew S Schroeder | Physical Therapy | Genesys Integrated Group Practice PC | 1096 S Belsey Rd G, Burton, MI 48509-1948 |
| Lewis A Jones | Diagnostic Radiology | Genesys Integrated Group Practice PC | 1096 S Belsay Rd, Suite J, Burton, MI 48509-1948 |
| Sandra Muller | Nurse Practitioner | Genesys Integrated Group Practice PC | 3441 Lapeer Rd, Flint, MI 48503-4427 |
| Craig W Holland | Family Practice | Genesys Integrated Group Practice PC | 3441 Lapeer Rd, Flint, MI 48503-4427 |
| Charles M Roll | Physical Therapy | Genesys Integrated Group Practice PC | 1096 S Belsey Rd G, Burton, MI 48509-1948 |
| Street Address |
7477 S STATE RD |
| City | GOODRICH |
| State | MI |
| Zip | 48438-8745 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Heidi B Hilton-kosch | Family Medicine | Ascension Medical Group Genesys | 7477 S State Rd, Goodrich, MI 48438-8745 |
| Valerie J Duerr | Family Practice | Genesys Integrated Group Practice PC | 7477 S State Rd, Goodrich, MI 48438-8745 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yamini Ramalingam | Family Medicine | 5339 S State Rd, Goodrich, MI 48438-8846 | |
| Wayne E Domenick | Chiropractic | 9037 S State Rd, Goodrich, MI 48438-8869 |
| City | GOODRICH |
| Zip Code | 48438 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | GOODRICH + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Mark Clark.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.