Dr. Melanie Anne Clark
Dermatologist
9200 W Wisconsin Ave
Milwaukee
, Wisconsin 53226-3522
Dr. Melanie Anne Clark
Dermatologist
9200 W Wisconsin Ave
Milwaukee
, Wisconsin 53226-3522
(414) 805-5323
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Dr. Melanie Anne Clark
- 9200 W Wisconsin Ave
- Milwaukee, WI
- Zip : 53226-3522
- Fax : (414) 805-5323
- Phone : (414) 805-5320
Second Address
- Dr. Melanie Anne Clark
- 9200 W Wisconsin Ave
- Milwaukee, WI
- Zip : 53226-3522
- Fax : (414) 805-5323
- Phone : (414) 805-5320
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207N00000X | Dermatologist | 125061558 | IL |
| Y | 207N00000X | Dermatologist | 67202 | WI |
National Provider Identifier
| NPI | 1033464185 |
|---|---|
| Provider Name | Dr. Melanie Anne Clark |
| First Address | Milwaukee, WI 53226-3522 |
| Second Address | Milwaukee, WI 53226-3522 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/07/2012 |
| Last Update Date | 15/08/2017 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1033464185 | (05) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.