Provider Demographics
NPI:1740494913
Name:CLEMENS, SETH WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:WILLIAM
Last Name:CLEMENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:350 HERITAGE WAY STE 2100
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3167
Mailing Address - Country:US
Mailing Address - Phone:406-257-8992
Mailing Address - Fax:406-257-8996
Practice Address - Street 1:350 HERITAGE WAY STE 2100
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3167
Practice Address - Country:US
Practice Address - Phone:406-257-8992
Practice Address - Fax:406-257-8996
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT19450207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1740494913Medicaid
MT1740494913Medicaid