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Contact Information

STEVEN M CLARK, MD
701 E COUNTY LINE ROAD
SUITE 201
GREENWOOD, IN46143
 Phone: 317-865-8000
 Fax: 317-865-8012
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for STEVEN M CLARK · (Male)

NPI Number 1285664052
Status Active
Credentials MD
Entity Individual
Enumeration date 07/04/2006
Last updated 11/27/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01052195A
  • IN Medicaid 200281580A
  • Other 10781002 CAQH ID
  • IN Other 5263695 AETNA ELIGIBILITY ID
  • IN Other 000000091132 ANTHEM BLUE CROSS
  • IN Other 000000014025 MDWISE/PROHEALTH
  • IN Other 020047583 MEDICARE RAILROAD
  • IN Other P01456868 MEDICARE RR
Hospital affiliation(s)
  • COMMUNITY HOSPITAL SOUTH - (Acute Care)
    1402 E COUNTY LINE RD S
    INDIANAPOLIS, IN 46227
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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