Provider Demographics
NPI:1760450597
Name:FLEMING, STEPHANIE I (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:I
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 TURF LANE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6392
Mailing Address - Country:US
Mailing Address - Phone:517-484-3000
Mailing Address - Fax:517-484-6358
Practice Address - Street 1:1560 TURF LANE
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6392
Practice Address - Country:US
Practice Address - Phone:517-484-3000
Practice Address - Fax:517-484-6358
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISF084870207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0331197OtherBCBS/BCN PROVIDER #
MI1017954OtherMCLAREN PROVIDER #
MI0770063OtherPHP FAMILYCARE PROVIDER #
MI4735503Medicaid
MIP00255980OtherRR MEDICARE PROVIDER #
MI0700418OtherPHP PROVIDER #
MII30766Medicare UPIN