Individual
DAVID H CLEMENTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4424 E FLAMINGO AVE, SUITE 110, NAMPA, ID 83687
(208) 288-4700
(208) 288-4720
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-500
ID
363A00000X
Physician Assistant
PA500
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010147756
BLUE SHIELD
ID
05
—
806955800
—
ID
01
—
P00159990
RAILROAD MEDICARE
ID
01
—
PANY9
BLUE CROSS
ID
01
—
PANZY7
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
10/22/2014
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