Clarke, Shanelle A.

Clarke, Shanelle A. is an individual health care provider with primary practice located at 1405 Clifton Rd Ne , Atlanta GA 30322-5510. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Cardiology is her primary health care specialty. Clarke, Shanelle A. can be contacted via phone (404) 256-2593.

Contact Information

Primary practice address
1405 Clifton Rd Ne Atlanta GA 30322-5510
Phone: (404) 256-2593
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 74968 Georgia
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 50214 Wisconsin

Profile Details

NPI number 1104973999
LBN Legal business name Clarke, Shanelle A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Jan 22nd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104973999 NPPES
Wisconsin MEDICAID 34768400
Wisconsin MEDICAID 003170465A
Wisconsin MEDICAID 1104973999

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