Provider Demographics
NPI:1821793183
Name:CLARK, SHEALAGH LEIGH (DO)
Entity Type:Individual
Prefix:DR
First Name:SHEALAGH
Middle Name:LEIGH
Last Name:CLARK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 ARNOLD WAY
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1207
Mailing Address - Country:US
Mailing Address - Phone:860-539-3080
Mailing Address - Fax:
Practice Address - Street 1:114 WOODLAND STREET
Practice Address - Street 2:DEPARTMENT OF OB-GYN
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105
Practice Address - Country:US
Practice Address - Phone:860-714-5170
Practice Address - Fax:860-714-8008
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program