Search › Michigan › 207Q00000X
Randall Clark, MD
NPI 1063573319 · on the registry since 2006
Practice
- Address
- 3980 Chicago Dr Sw Ste 200
Grandville, MI 49418 - Phone
- (616) 381-5181
- Fax
- (616) 381-5178
- Organisation at this address
- Living Roots Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-07-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan