Clark Center for Comprehensive Medicine P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CLARK CENTER FOR COMPREHENSIVE MEDICINE P.C.

Practice address

29521 Ford Rd
Garden City, MI 48135

Phone

(734) 367-1205

Fax

(734) 367-1214

NPI assigned

Mar 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald Godfrey ClarkNPI 1386669570

Title

Owner

Phone

(734) 367-1205

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Donald Godfrey Clark, P.A.-C

  • Internal Medicine Physician
  • Garden City, MI
  • NPI 1386669570
  Medicare reassignment Authorized official
• Jacob Craze, NP

  • Nurse Practitioner
  • Bingham Farms, MI
  • NPI 1558959403
  Medicare reassignment NPD
• Victor P Al-Matchy, M.D.

  • Internal Medicine Physician
  • Sterling Heights, MI
  • NPI 1609811975
  Medicare reassignment
• Hazem Samir-Moez, MD

  • Internal Medicine Physician
  • Hamtramck, MI
  • NPI 1992734214
  NPD (past)
• Sandeep S Sohal, MD

  • General Practice Physician
  • Garden City, MI
  • NPI 1992833206
  NPD (past)
• Fady Fayad Fayad, M.D.

  • Internal Medicine Physician
  • Riverside, CA
  • NPI 1205862612
  NPD (past)
• Marwan F Hammoud, MD

  • Family Medicine Physician
  • Green Brook, NJ
  • NPI 1851390470
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552608000000",
    "number": "1861521031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29521 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "481352319",
            "telephone_number": "734-367-1205",
            "fax_number": "734-367-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29521 FORD RD",
            "city": "GARDEN CITY",
            "state": "MI",
            "postal_code": "48135",
            "telephone_number": "734-367-1205",
            "fax_number": "734-367-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK CENTER FOR COMPREHENSIVE MEDICINE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2019-03-15",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "GODFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-367-1205"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "DB2730",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "110H221360",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam Edward Chornoby, D.O.
• Navya Chundu, M.D.
• James Chung, D.O.
• Citizens Care Services, Inc.
• City of Garden City
• Donald Godfrey Clark, P.A.-C
• William Russell Clugston, DC
• Alysse Jaclyn Cohen, M.D.
• Gary A. Cohen, D.D.S.
• Community Care RX LLC

• Internal Medicine Physician in Garden City, MI
• Providers in Garden City, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.