DR. MATTHEW THOMAS CLARK M.D. NPI 1467872044

NPI Information

NPI: 1467872044
Provider Name: DR. MATTHEW THOMAS CLARK, M.D.
Classification: Pediatrics - 2080P0216X
Entity Type: Individual

Specialization: Pediatric Rheumatology

PECOS Registration: Yes

Address:
200 PATEWOOD DR STE A200
GREENVILLE, SC
ZIP 29615
Phone: (864) 454-5004
Get Directions

DR. Matthew Thomas Clark, M.D. is a pediatric rheumatology pediatrics in Greenville, SC. The provider is a pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. DR. Matthew Thomas Clark, M.D. NPI is 1467872044. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

200 PATEWOOD DR STE A200
GREENVILLE, SC
ZIP 29615-580
Phone: (864) 454-5004
Fax: (864) 241-9202

The NPI 1467872044 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/22/2014 and was last updated on 9/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program				No
2	2080P0216X	Pediatrics	Pediatric Rheumatology	87391	SOUTH CAROLINA	Yes
3	208000000X	Pediatrics		55984	TENNESSEE	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PENDING	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »