Provider Demographics
NPI:1477197085
Name:FLEMING, MEREDITH KATHRYN (PA-C)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:KATHRYN
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-2138
Mailing Address - Country:US
Mailing Address - Phone:740-566-4621
Mailing Address - Fax:740-466-4621
Practice Address - Street 1:485 TOM HALL ST STE 101
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-2353
Practice Address - Country:US
Practice Address - Phone:803-228-7972
Practice Address - Fax:803-228-7974
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09511208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty