Individual provider · Type 1 NPI

Kenneth Clark, MD

Specialist · Milwaukee, WI

NPI number 1356325518 Active · reactivated Apr 5, 2006

Practice location

2025 E Newport Ave
Milwaukee, WI 53211-2906

Call (414) 961-3841 Map

Mailing address

500 W Brown Deer Rd, Suite 202
Bayside, WI 53217-1627

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X22673 (WI)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1356325518

Kenneth Clark, MD's National Provider Identifier is 1356325518, issued on Dec 1, 2005. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Milwaukee, WI. The record was last updated on Aug 13, 2007.