WILLIAM D CLARK MD
NPI 1922096718
Pediatrics - Neonatal-Perinatal Medicine in Dearborn, MI

Q: What is William Clark's NPI number?

The NPI number for William Clark is 1922096718. It was assigned to this individual provider in the NPPES registry on October 6, 2005.

Q: What is William Clark's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Neonatal-Perinatal Medicine, with taxonomy code 2080N0001X.

Q: When was this NPI record last updated?

The NPPES record for William Clark was last updated on February 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 06, 2005PECOS Enrolled

18101 OAKWOOD BLVD STE 124, DEARBORN, MI 48124(313) 586-5011(313) 592-7134 Get Directions Write a Review

NPPES record last updated: February 20, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About William D Clark Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIAM D CLARK MD (NPI 1922096718) is an individual neonatal-perinatal medicine provider in Dearborn, Michigan, licensed in Michigan (4301068667) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS and maintains a secondary practice location in Dearborn.

NPPES Registry Identity

NPI1922096718

Entity TypeIndividualMale

Primary Taxonomy2080N0001X

Provider Legal NameWILLIAM D CLARKCredential: MD

Location Address18101 OAKWOOD BLVD STE 124Dearborn, MI 48124-4089

Mailing Address26901 Beaumont Blvd Ste 3dSouthfield, MI 48033-3849

Phone(313) 586-5011

Fax(313) 592-7134

Sole ProprietorNo

Enumeration DateOctober 6, 2005

Last NPPES UpdateFebruary 20, 2024

NPPES CertifiedFebruary 20, 2024

✔ NPI 1922096718 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Neonatal-Perinatal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080N0001X

License✔ Licensed in MI · 4301068667

Definition

A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

18101 OAKWOOD BLVD STE 124, Dearborn, MI 48124

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Secondary Practice Location 1

Location 118501 Rotunda Dr Ste 200Dearborn, MI 48124-3891 · Phone (313) 996-1960

Other Identifiers 1

Medicaid4577146MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

William D Clark Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEREK BAIR MD

Pediatrics (Neonatal-Perinatal Medicine)

18101 OAKWOOD BLVD STE 124, DEPT OF NEONATOLOGY
DEARBORN, MI 48124

Wayne County (313) 593-7490

STACEY ELIZABETH TILBURY NNP

Nurse Practitioner (Neonatal)