Individual
DAVID L NIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
107 DILWORTH ST, GLENDIVE, MT 59330-2053
(406) 345-8935
(406) 345-8908
Mailing address
107 DILWORTH ST, GLENDIVE, MT 59330-2053
(406) 345-8935
(406) 345-8908
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA10004978
WA
363AM0700X
Medical Physician Assistant
Primary
—
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0207865
L&I
WA
05
—
8500225
—
WA
01
—
8941215
L&I CVC
WA
01
—
9947NI
REGENCE RIDER
WA
Enumeration date
10/31/2006
Last updated
08/06/2024
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