Provider Demographics
NPI:1487647046
Name:CLEMENTS, DAVID A II (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:CLEMENTS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4 VANDERBILT PARK DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1700
Mailing Address - Country:US
Mailing Address - Phone:828-258-0397
Mailing Address - Fax:828-258-3390
Practice Address - Street 1:4 VANDERBILT PARK DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1700
Practice Address - Country:US
Practice Address - Phone:828-258-0397
Practice Address - Fax:828-258-3390
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801212207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1169YOtherBLUE CROSS BLUE SHIELD NC
NC891169YMedicaid
NCG82602Medicare UPIN
NC891169YMedicaid