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NPI Code Detail

MEDICARE: MICHAEL T CLARKE MD

MEDICARE: MICHAEL T CLARKE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician229062NY
2207XS0114XAdult Reconstructive Orthopaedic Surgery Physician229062NY

General Provider Information

NPI Number : 1871598805
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL T CLARKE MD
Provider Business Mailing Address
First Line : 5719 WIDEWATERS PKWY
Second Line :
City : SYRACUSE
State : NY
Zip : 13214-1880
Country : US
Telephone Number : 315-251-3100
Fax Number : 315-449-9923
Provider Business Practice Location Address
First Line : 5719 WIDEWATERS PKWY
Second Line :
City : SYRACUSE
State : NY
Zip : 13214-1880
Country : US
Telephone Number : 315-251-3100
Fax Number : 315-449-9923
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 04/05/2018

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Directions to “ MICHAEL T CLARKE MD” Practice Location

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