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Contact Information

MICHAEL T CLARK
705 RILEY HOSPITAL DR
INDIANAPOLIS, IN46202-5109
 Phone: 317-944-8906
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
 

Hospice and Palliative Medicine

2080H0002X 37 Physician/Pediatric Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

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

NPI Number 1780147298
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2019
Last updated 04/27/2026 - About a month ago
Sole proprietor 1 No
Identifiers
  • IN License # 01088048A
  • OH License # 35.154087
Hospital affiliation(s) Not Available
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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