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Contact Information

MICHAEL E CLARK, MD
4 SHERIDAN DRIVE
FAIRFIELD, ME04937
 Phone: 207-861-5000
 Fax: 207-861-5001
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for MICHAEL E CLARK · (Male)

NPI Number 1053387936
Status Active
Credentials MD
Entity Individual
Enumeration date 02/28/2006
Last updated 10/16/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • ME License # 013687
  • ME Medicaid 1053387936
  • ME Medicaid 272100099
Hospital affiliation(s)
  • MAINE GENERAL MEDICAL CENTER - (Acute Care)
    35 MEDICAL CENTER PARKWAY
    AUGUSTA, ME 04330
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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