Individual
DR. SHANELLE A. CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2220 N DRUID HILLS RD NE, ATLANTA, GA 30329-3117
(404) 256-2593
(770) 488-9408
Mailing address
2970 BRANDYWINE RD STE 125, ATLANTA, GA 30341-5521
(404) 256-2593
(770) 488-9408
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
74968
GA
2080P0203X
Pediatric Critical Care Medicine Physician
50214
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003170465A
—
GA
05
—
1104973999
—
WI
05
—
34768400
—
WI
Enumeration date
01/04/2007
Last updated
04/24/2026
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