DR. MICHAEL B CLARK (NPI# 1538115423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538115423 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL B CLARK |
| Credential | M.D. |
| Practice Address |
2002 Medical Pkwy Ste 235 Annapolis MD 21401-3046 |
| Practice Telephone | 4102662770 |
| Practice Fax Number | 4108416251 |
| Mailing Telephone | 4102662770 |
| Mailing Fax Number | 4108416251 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-02-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
D0056183 | MD | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME94700 | FL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
28302 | SC | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
200000198 | NC | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD416976 | PA | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
35.080358 | OH | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
D0056183 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 017000300 | 05 | |
| MD | AAD PG COUNTY | 019419A80 | 01 |
| MD | BCBS | 10690029 | 01 |
| MD | AETNA HMO/POS | 2622593 | 01 |
| MD | AAD AA COUNTY | N899 | 01 |
| MD | AETNA PPO | 8317071 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
| 1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
| 1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
| 1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
| 1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
| 1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
| 1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
| Street Address |
2002 MEDICAL PKWY STE 235 |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21401-3046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366448953 | Ayanna L James | Obstetrics & Gynecology | 2002 Medical Pkwy, Suite 635, Annapolis, MD 21401-3046 | 2005-06-28 |
| 1336611466 | Lauren Mason | Social Worker | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-12-31 |
| 1184131542 | Amanda Nicole Minnitte | Physical Therapy Assistant | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-01-08 |
| 1255878526 | Maryland Medicinal LLC | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, Suite 150, Annapolis, MD 21401-3046 | 2017-01-25 |
| 1669917993 | Back To Fit Inc. | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, 150, Annapolis, MD 21401-3046 | 2016-12-22 |
| 1821549528 | Anne Arundel Physician Group, LLC | Family Medicine | 2002 Medical Pkwy, Suite 460, Annapolis, MD 21401-3046 | 2016-10-18 |
| 1114372497 | Anne Arundel Physician Group, LLC | Clinical Neuropsychologist | 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 | 2016-04-25 |
| 1487040036 | Gaurav Srivastava | Ophthalmology | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2015-04-10 |
| 1164828679 | Med-park LLC | Pharmacy | 2002 Medical Pkwy, Ste 170, Annapolis, MD 21401-3046 | 2014-11-10 |
| 1992147631 | Zachary Scott La Fratta | Audiologist | 2002 Medical Pkwy, Suite 230 Sajak Building, Annapolis, MD 21401-3046 | 2013-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377154 | Michael Khorsandi | Student in an Organized Health Care Education/Training Program | 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 | 2020-05-15 |
| 1275172033 | Katrice N Nelson | Massage Therapist | Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 | 2019-12-27 |
| 1548803521 | Victoria Reimnitz | Behavioral Analyst | 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 | 2019-10-23 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| 1316504848 | Sherina Maryam Shamsa | Counselor | 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 | 2019-05-21 |
| 1497225288 | Jerilyn Deitch | Speech-Language Pathologist | Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 | 2018-12-05 |
| 1487124038 | Lucinda W Mimms | Speech-Language Pathologist | 2644 Riva Rd., Annapolis, MD 21401 | 2018-11-27 |
| 1487145496 | Michelle Baudean | Behavior Technician | 1919 West St Ste 201, Annapolis, MD 21401 | 2018-05-24 |
| 1730678954 | Stephanie Ruth Streb | Registered Nurse | 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 | 2018-05-02 |
| 1780183947 | Annapolis Sleep Center LLC | Clinic/Center | 2451 Riva Rd, Annapolis, MD 21401 | 2018-02-02 |
| Find all providers in zip 21401 | ||||
| Taxonomy Code | 2085N0700X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Neuroradiology |
| A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942281100 | Timothy S. Eckel | Radiology | 2002 Medical Pkwy, Suite 235, Annapolis, MD 21401-3046 | 2005-11-07 |
| 1114918091 | Kerry J. Thompson | Radiology | 2002 Medical Pkwy, Suite #235, Annapolis, MD 21401-3046 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407230485 | Melike Guryildirim | Radiology | 4940 Eastern Ave Bldg 1, Baltimore, MD 21224-2735 | 2015-07-19 |
| 1225472392 | Kenedy Andon Foryoung | Radiology | 7701 Greenbelt Rd Ste 102, Greenbelt, MD 20770-6508 | 2013-04-19 |
| 1053671636 | Nishanth Khanna | Radiology | 1800 Orleans St # 7128, Baltimore, MD 21287-0010 | 2012-05-17 |
| 1003198938 | Ravishankar Shivashankar | Radiology | 22 S Greene St # G2k14, Baltimore, MD 21201-1544 | 2011-09-16 |
| 1437341435 | Nancy D Richert | Radiology | National Institute of Neurologic Disorders and Stroke, Bldg 10, Rm B1n256 Nih, Bethesda, MD 20892-0001 | 2007-08-14 |
| 1104038520 | Arthur Elihu Rosenbaum | Radiology | 22 Treadwell Ct, Lutherville, MD 21093-3764 | 2007-05-06 |
| 1467598565 | Gerald Martin Wyse | Radiology | 600 N Wolfe Stree, Baltimore, MD 21287-0001 | 2007-01-29 |
| 1437203346 | Ovsev Uzuner | Radiology | 600 N Wolfe St # 108, Baltimore, MD 21287-0005 | 2007-01-22 |
| 1225123318 | Craig Nicolas Bash | Radiology | 7831 Woodmont Ave, Bethesda, MD 20814-3007 | 2006-10-04 |
| 1790880599 | Taik-kun Kim | Radiology | 322 E Antietam St Ste 106, Hagerstown, MD 21740-5736 | 2006-09-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. MICHAEL B CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.