Search › Michigan › 207T00000X
Justin Clark, MD
NPI 1598945644 · on the registry since 2007 · sole proprietor
Practice
- Address
- 414 Plymouth Ne
Grand Rapids, MI 49505 - Phone
- (616) 454-3465
- Fax
- (616) 242-7060
Registry record
- Primary taxonomy
- 207T00000X
207T00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-06-26
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