National Provider Identifier Database

ALYSA M CLARK, MD – NPI #1356903371
Pediatric Emergency Medicine

Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.


Contact Information

ALYSA M CLARK, MD
100 MICHIGAN ST NE # MC049
GRAND RAPIDS, MI49503-2560
Phone: 616-391-1680
Fax:
Website:
Specialty Taxonomy Code
* Pediatric Emergency Medicine 207PP0204X
Emergency Medicine 207P00000X

* Indicates primary specialty

NPI Profile & details for ALYSA M CLARK

NPI Number 1356903371
Credentials MD
Entity Individual
Enumeration date 06/29/2019
Last updated 04/09/2024 - About 2 years ago
Sole proprietor1 No
Identifiers
  • MI License #: 4301504949
  • MI License #: 4351045601
Hospital affiliation n/a

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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