Individual
DR. MICHAEL P CLEMENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 SUDDERTH DR, RUIDOSO, NM 88345-7067
(575) 630-1055
(575) 630-1066
Mailing address
1701 SUDDERTH DR, RUIDOSO, NM 88345-6114
(575) 630-1055
(575) 630-1066
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
96-218
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q0066
—
NM
Enumeration date
12/22/2006
Last updated
02/03/2009
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