Individual
DAVID CLEMENTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1402 E COUNTY LINE RD, INDIANAPOLIS, IN 46227-0963
(317) 887-7805
Mailing address
6626 E 75TH ST, STE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01077100A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01824432
RR PTAN
IN
Enumeration date
04/29/2013
Last updated
11/27/2023
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