Active NPI 1548495336 Individual Practitioner Male Practitioner

Dr. Shane Chamberlain Clark , MD

Dermatology • Wooster, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Shane Clark, MD is a certified Dermatology practicing in Wooster, OH. With approximately 17 years of clinical experience since graduating from Ohio State University College Of Medicine in 2009, Dr. Clark delivers high-quality medical care to the local community at 347 W MILLTOWN RD STE B.

Dr. Clark is affiliated with Dermatologists Of Southwestern Ohio, Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

347 W Milltown Rd Ste B

Wooster, OH 446917216

Telephone 3303451540

Fax 3303451541

Medicare Profile & Education

Medical School

Ohio State University College Of Medicine

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Wooster, OH

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs Matches City Avg

City Avg: 17.0 Yrs

State Avg: 23.5 Yrs

Regional Practice Density

2 Specialists

Practicing in Wooster, OH (528 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

48.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Clark (17 Years) 17 Yrs

Wooster Specialty Average (17.0 Years) 17.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,666	546	$10.80	$6.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,162	845	$221.38	$120.35
17000 Destruction of skin growth	913	753	$111.39	$49.72
99213 Established patient office or other outpatient visit, typically 15 minutes	632	529	$155.77	$85.37
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	507	93	$5.00	$0.98
17110 Destruction of up to 14 skin growths	474	412	$190.03	$99.24
11102 Tangential biopsy of single skin lesion	255	225	$174.09	$79.93
17004 Destruction of precancer skin growth, 15 or more growths	102	86	$279.11	$154.90
11900 Injection into skin growth, 1-7 growths	81	62	$95.31	$36.81
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	81	81	$287.82	$158.36
10060 Simple or single drainage of skin abscess	79	73	$209.74	$115.14
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	68	57	$301.89	$147.28
11103 Biopsy of related skin growth, each additional growth	66	43	$88.88	$46.11
17111 Destruction of skin growth, 15 or more growths	61	52	$223.58	$120.85
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	60	60	$191.95	$105.33
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	49	48	$95.22	$52.99
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	45	33	$27.45	$13.33
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	25	24	$319.85	$161.41
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	23	21	$350.16	$182.95
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	14	14	$327.20	$179.58
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	13	13	$521.36	$221.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,507	519	$10.80	$6.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,123	813	$221.38	$121.67
17000 Destruction of skin growth	889	713	$111.39	$49.16
99213 Established patient office or other outpatient visit, typically 15 minutes	613	510	$155.02	$85.94
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	544	104	$5.22	$1.07
17110 Destruction of up to 14 skin growths	446	392	$190.03	$99.08
11102 Tangential biopsy of single skin lesion	305	272	$174.09	$82.87
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	97	72	$301.89	$140.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	93	93	$287.26	$157.32
10060 Simple or single drainage of skin abscess	89	83	$209.74	$116.75
11103 Biopsy of related skin growth, each additional growth	84	59	$88.88	$45.29
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	68	48	$40.00	$13.33
11900 Injection into skin growth, 1-7 growths	67	58	$95.31	$34.97
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	63	63	$96.23	$53.52
17004 Destruction of precancer skin growth, 15 or more growths	60	56	$279.11	$159.17
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	58	58	$192.20	$107.27
17111 Destruction of skin growth, 15 or more growths	42	37	$223.58	$123.19
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	29	29	$319.85	$173.42
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	22	21	$209.83	$101.74
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	18	16	$199.82	$85.36
69100 Biopsy of ear	17	17	$167.53	$64.33
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	17	16	$350.16	$189.14
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	16	12	$172.67	$65.28
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	13	13	$521.36	$253.72
11200 Removal of skin tag, 1-15 skin tags	12	12	$151.97	$61.25
11311 Shaving of skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm	12	11	$236.97	$129.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,615	506	$10.80	$6.37
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	996	718	$219.74	$123.21
17000 Destruction of skin growth	846	677	$111.39	$51.50
99213 Established patient office or other outpatient visit, typically 15 minutes	699	571	$155.24	$87.62
17110 Destruction of up to 14 skin growths	426	366	$190.03	$102.11
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	402	83	$5.00	$1.14
11102 Tangential biopsy of single skin lesion	290	255	$174.09	$87.16
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	117	95	$301.89	$148.77
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	93	93	$287.45	$162.67
11103 Biopsy of related skin growth, each additional growth	83	56	$88.88	$48.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	80	78	$95.95	$54.10
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	76	76	$192.10	$109.00
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	63	51	$40.00	$13.72
10060 Simple or single drainage of skin abscess	62	60	$209.74	$115.92
11900 Injection into skin growth, 1-7 growths	51	39	$95.31	$40.70
17111 Destruction of skin growth, 15 or more growths	36	28	$223.58	$126.77
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	32	31	$319.85	$170.52
17004 Destruction of precancer skin growth, 15 or more growths	27	26	$279.11	$160.82
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	26	25	$350.16	$197.31
11200 Removal of skin tag, 1-15 skin tags	24	23	$151.97	$57.69
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	15	13	$209.83	$109.87
69100 Biopsy of ear	13	13	$167.53	$75.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,527	531	$10.85	$6.16
17000 Destruction of skin growth	903	700	$111.54	$51.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	867	586	$221.46	$125.95
99213 Established patient office or other outpatient visit, typically 15 minutes	851	668	$155.86	$88.76
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	511	102	$5.00	$1.26
17110 Destruction of up to 14 skin growths	418	346	$190.24	$101.97
11102 Tangential biopsy of single skin lesion	322	276	$174.28	$86.88
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	119	94	$302.03	$147.90
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	101	101	$287.89	$163.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	100	100	$191.90	$109.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	96	87	$95.33	$53.93
11103 Biopsy of related skin growth, each additional growth	93	66	$88.88	$50.24
10060 Simple or single drainage of skin abscess	86	84	$209.83	$116.37
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	82	61	$40.00	$13.47
11900 Injection into skin growth, 1-7 growths	68	43	$105.00	$42.45
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	37	32	$350.13	$184.41
11200 Removal of skin tag, 1-15 skin tags	35	33	$152.28	$60.79
17111 Destruction of skin growth, 15 or more growths	33	26	$223.70	$127.76
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	31	29	$304.75	$162.73
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	29	24	$319.83	$163.86
17004 Destruction of precancer skin growth, 15 or more growths	24	21	$279.07	$159.49
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	15	14	$327.20	$180.74
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	12	12	$209.89	$104.91
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$124.13	$70.93

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,016	566	$10.90	$5.79
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,050	785	$184.33	$106.37
17000 Destruction of skin growth	924	732	$111.53	$49.71
99213 Established patient office or other outpatient visit, typically 15 minutes	512	410	$126.67	$73.36
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	361	77	$4.92	$1.45
17110 Destruction of up to 14 skin growths	340	295	$184.69	$101.37
11102 Tangential biopsy of single skin lesion	338	290	$165.27	$87.49
11103 Biopsy of related skin growth, each additional growth	126	88	$88.30	$50.90
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	109	78	$301.70	$142.09
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	78	52	$38.57	$13.62
10060 Simple or single drainage of skin abscess	65	63	$205.50	$112.72
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	62	62	$180.93	$106.03
99202 New patient office or other outpatient visit, typically 20 minutes	61	61	$130.55	$74.61
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	59	50	$359.87	$185.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	56	52	$87.11	$43.17
17004 Destruction of precancer skin growth, 15 or more growths	46	43	$264.20	$154.06
11900 Injection into skin growth, 1-7 growths	46	37	$105.00	$38.65
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	35	32	$327.39	$162.66
17111 Destruction of skin growth, 15 or more growths	32	25	$223.53	$123.53
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	25	23	$311.27	$164.54
69100 Biopsy of ear	20	19	$164.64	$71.85
11200 Removal of skin tag, 1-15 skin tags	13	12	$154.55	$61.58
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	12	11	$195.11	$98.80
17273 Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals	11	11	$360.96	$195.28
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	11	11	$246.10	$109.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,619	614	$17.97	$5.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,127	810	$169.53	$105.46
17000 Destruction of skin growth	999	766	$115.84	$49.12
99213 Established patient office or other outpatient visit, typically 15 minutes	572	445	$103.72	$71.82
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	437	75	$5.00	$1.60
17110 Destruction of up to 14 skin growths	427	359	$156.22	$98.32
11102 Tangential biopsy of single skin lesion	378	311	$138.73	$80.31
11103 Biopsy of related skin growth, each additional growth	141	86	$75.00	$51.14
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	123	93	$310.89	$144.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	105	105	$153.40	$104.66
99202 New patient office or other outpatient visit, typically 20 minutes	100	100	$124.00	$73.76
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	99	62	$36.87	$16.05
17004 Destruction of precancer skin growth, 15 or more growths	92	80	$241.20	$146.96
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	81	67	$395.80	$173.41
10060 Simple or single drainage of skin abscess	56	53	$189.11	$110.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	48	48	$80.21	$42.88
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	40	38	$364.25	$168.52
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	34	29	$342.21	$164.88
17111 Destruction of skin growth, 15 or more growths	34	22	$227.35	$123.92
11900 Injection into skin growth, 1-7 growths	34	23	$103.53	$43.32
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	26	23	$331.54	$160.74
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	18	18	$173.33	$112.12
11200 Removal of skin tag, 1-15 skin tags	15	13	$200.00	$71.34
11104 Punch biopsy, first skin growth	15	15	$176.67	$111.08
69100 Biopsy of ear	14	14	$146.43	$85.40
11310 Shaving of 0.5 centimeters or less skin growth of face, ears, eyelids, nose, lips, or mouth	12	12	$165.00	$104.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,214	541	$20.00	$4.85
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	986	725	$175.00	$100.17
17000 Destruction of skin growth	853	670	$120.00	$48.87
99213 Established patient office or other outpatient visit, typically 15 minutes	512	394	$105.00	$67.65
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	507	80	$5.00	$1.81
17110 Destruction of up to 14 skin growths	294	246	$158.00	$97.41
11100 Biopsy of single growth of skin and/or tissue	259	223	$165.00	$88.51
17004 Destruction of precancer skin growth, 15 or more growths	126	106	$250.00	$134.30
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	125	125	$155.00	$100.22
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	106	70	$40.00	$18.82
11101 Biopsy of each additional growth of skin and/or tissue	102	65	$80.00	$30.43
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	75	57	$320.00	$137.48
99202 New patient office or other outpatient visit, typically 20 minutes	64	64	$125.00	$68.96
17111 Destruction of skin growth, 15 or more growths	62	51	$250.00	$121.78
10060 Simple or single drainage of skin abscess	52	50	$195.00	$108.40
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	45	40	$420.00	$175.51
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	31	24	$370.00	$151.29
11900 Injection into skin growth, 1-7 growths	29	17	$105.00	$46.81
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	22	21	$370.00	$158.61
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	14	$85.00	$40.56

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	3,213	526	$20.00	$5.15
17000 Destruction of skin growth	835	634	$120.00	$47.82
99213 Established patient office or other outpatient visit, typically 15 minutes	654	525	$105.00	$67.20
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	574	452	$175.00	$99.01
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	533	75	$5.00	$1.80
17110 Destruction of up to 14 skin growths	294	245	$158.00	$95.40
11100 Biopsy of single growth of skin and/or tissue	293	253	$165.00	$85.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	161	161	$155.00	$100.06
99202 New patient office or other outpatient visit, typically 20 minutes	126	126	$125.00	$69.21
17004 Destruction of precancer skin growth, 15 or more growths	110	89	$250.00	$137.79
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	108	70	$39.65	$22.90
11101 Biopsy of each additional growth of skin and/or tissue	100	69	$80.00	$30.45
17111 Destruction of skin growth, 15 or more growths	64	53	$250.00	$119.01
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	62	49	$320.00	$129.05
10060 Simple or single drainage of skin abscess	51	46	$195.00	$97.50
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	45	36	$420.00	$167.20
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	41	38	$85.00	$39.63
17272 Destruction of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	29	27	$370.00	$147.31
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	28	25	$370.00	$151.86
69100 Biopsy of ear	17	15	$155.00	$62.32
11900 Injection into skin growth, 1-7 growths	16	12	$105.00	$40.68
17263 Destruction of cancer skin growth of trunk, arms, or legs, 2.1-3.0 cm	14	12	$370.00	$169.31
17273 Destruction of malignant growth (2.1 to 3.0 centimeters) of scalp, neck, hands, feet, or genitals	14	14	$420.00	$191.14

Medical Specialties & State Licenses

CMS Verified: 2024-04-09

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License OH 35121081

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Hospital & Practice Group Affiliations

Dermatologists Of Southwestern Ohio, Llc

347 W Milltown Rd, Wooster, OH 446917216

Phone: 3303451540

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Rachel Hartong , APRN

Nurse Practitioner - Family

NPI 1629773049

Advanced Practice Registered Nurse

Dr. Sireesha Clark , MD

Ophthalmology

NPI 1982834438

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location April 09, 2024

Registered at 347 W MILLTOWN RD STE B, WOOSTER, OH 446917216 (Tel: 3303451540)

📍

Updated Business Mailing Address April 09, 2024

Registered at 347 W MILLTOWN RD STE B, WOOSTER, OH 446917216 (Tel: 3303451540)

✅

NPI Profile Active August 04, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location August 04, 2016

Registered at 5300 FAR HILLS AVENUE, DAYTON, OH 454292347 (Tel: 9374337536)

📍

Updated Business Mailing Address August 04, 2016

Registered at 5300 FAR HILLS AVENUE, DAYTON, OH 454292347 (Tel: 9374337536)

👤

Provider Name / Credentials Updated August 04, 2016

Recorded as SHANE CLARK, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 04, 2016

Dermatology (License #35121081 in OH)

🟢

Initial NPI Registration & Enumeration May 21, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1548495336

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 21, 2009

Last Update: April 09, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

347 W Milltown Rd Ste B

Wooster, OH 446917216

Phone: 3303451540

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.