Doctor Name: | MR. MARTIN JOSEPH CLINARD |
NPI Number: | 1003831298 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PA-C |
License Number: | 5601004170 |
Business Practice Address: | 501 S Drake Rd Kalamazoo, MI - 490093234 |
Business Phone Number: | 2693431296 |
Business Fax Number: | 2693448485 |
Mailing Address: | 501 S Drake Rd, KALAMAZOO |
State: | MI |
Postal Code: | 490093234 |
Phone Number: | 2693431296 |
Fax Number: | 2693448485 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 01/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 5601004170 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |