Individual
DR. CHRISTOPHER SHADBURN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
777 37TH ST, VERO BEACH, FL 32960-4873
(772) 778-7217
Mailing address
906 TULIP LN, VERO BEACH, FL 32963-2101
(772) 234-1060
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME80173
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261068000
—
FL
Enumeration date
09/20/2006
Last updated
07/08/2007
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