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Nicole M Clark (PA-C)

Nicole M Clark (PA-C) is a health care provider specializes in Physician Assistant. She is associated with medical group practice SELF MEDICAL GROUP and is affiliated with 2 hospitals as shown below.

profile-icon Basic Information

Practice Location 595 Newberry Hwy, Saluda, SC 29138-7808, US
Practice Location Phone864-445-2500
Practice Location Fax864-445-3956
Specialty InPhysician Assistant
Medical SchoolOther
Graduation Year2008
NPI ?1114164142
PECOS ID7810053212
Enrollment IDI20131226000996
Entity TypeIndividual
Enumeration Date ? Jan 13, 2009
Last Update Date ? May 2, 2017
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
PECOS: Provider Enrollment, Chain, and Ownership System.

specialty-icon Specialties & Licenses of Nicole M Clark

SpecialtySpecializationLicenseLicense State
Physician Assistant 2017South Carolina

Medicare-icon Medicare Participation of Nicole M Clark

Accepts Medicare AssignmentYes
Report Quality Measures
Use Electronic Health Records
Committed to Teart Health Through the Million HeartsĀ® initiative

affiliation-icon Hospital & Group Practice Affiliations of Nicole M Clark

Medical Group PracticeSelf Medical Group
Affiliation 1 Self Regional Healthcare
Affiliation 2 Newberry County Memorial Hospital

legacy-id-icon Legacy Provider IDs of Nicole M Clark

Provider IdIssuer StateIssuer TypeIssuer
1932PASouth CarolinaMedicaid