Provider Demographics
NPI:1407187057
Name:RICHARD C. FLEMING, M.D., P.A.
Entity Type:Organization
Organization Name:RICHARD C. FLEMING, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-642-8157
Mailing Address - Street 1:619 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3707
Mailing Address - Country:US
Mailing Address - Phone:910-642-8157
Mailing Address - Fax:910-914-0995
Practice Address - Street 1:619 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3707
Practice Address - Country:US
Practice Address - Phone:910-642-8157
Practice Address - Fax:910-914-0995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE81811Medicare UPIN