Provider Demographics
NPI:1073565024
Name:FLEMING, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:101 S FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-7637
Practice Address - Country:US
Practice Address - Phone:573-882-4464
Practice Address - Fax:573-884-8142
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7727207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO402240OtherUNITED HEALTHCARE
MO148338OtherBLUE SHIELD/BLUE CHOICE
MO117182OtherHEALTHLINK
MO201217403Medicaid
MO201217403Medicaid
MO021011444Medicare PIN
MO402240OtherUNITED HEALTHCARE
MO117182OtherHEALTHLINK
MO968375236Medicare PIN