Individual
DR. HEATHER MICHELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1316 E 7TH ST, AUBURN, IN 46706-2538
(260) 373-4000
(260) 482-4442
Mailing address
608 UNION CHAPEL RD, FORT WAYNE, IN 46845-9357
(260) 482-4440
(260) 482-4442
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01069280A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01069280A
IN PHYSICIAN LICENSE
IN
Enumeration date
06/30/2008
Last updated
05/07/2024
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