Provider Demographics
NPI:1497791529
Name:FLEMING, CALEB JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:JOHN
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1301 MERCY DR
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-1837
Mailing Address - Country:US
Mailing Address - Phone:231-739-9492
Mailing Address - Fax:231-739-8932
Practice Address - Street 1:1301 MERCY DR
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-1837
Practice Address - Country:US
Practice Address - Phone:231-739-9492
Practice Address - Fax:231-739-8932
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301048869208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF01767Medicare UPIN