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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SHANE B CLARK, DO

Active

SHANE B CLARK, DO is a Hematology healthcare provider located in FLEMING ISLAND, Florida. NPI 1902391477 is currently active in the NPPES registry. Verify at CMS.

Hematology · FLEMING ISLAND, FL

Registration Details

NPI Number
1902391477
Provider Type
Individual
Gender
Male
NPI Issued
Jun 27, 2018 (8.1727817094043 yrs)
Last Updated
Apr 30, 2025
Licenses
OS21375 (FL)
OS21375 (FL)
OS21375 (FL)

Practice Information

Address
2310 VILLAGE SQUARE PKWY STE 106C
FLEMING ISLAND, FL, 320036409
Browse FL providers · Browse ZIP 32003
Phone
9042027300
Fax
9042022754
Primary Specialty
Hematology
207RH0003X
Additional Specialty
Medical Oncology
Additional Specialty
Hematology

Other Hematology Providers in FLEMING ISLAND, FL

Name Credential NPI
DR. MEHDI M MOEZI MD 1053316190
SATISH P SHANBHAG MD,MPH 1215140454
DR. HEMA MADHAVI VANKAYALA MD 1023227691
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.