Provider Demographics
NPI:1780645093
Name:YU-FLEMING, CANDICE MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:MICHELLE
Last Name:YU-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 1:2022 KELLE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-8708
Mailing Address - Country:US
Mailing Address - Phone:219-364-3616
Mailing Address - Fax:219-364-3610
Practice Address - Street 1:3630 WILLOWCREEK RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-5075
Practice Address - Country:US
Practice Address - Phone:219-364-3700
Practice Address - Fax:219-364-3610
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058114207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00207872OtherRAILROAD
000000521513OtherANTHEM
IN200522990AMedicaid
5251392OtherAETNA
5251392OtherAETNA
INP00207872OtherRAILROAD