Provider Demographics
NPI:1932514718
Name:DITTMER FLEMIG, ALISON (MD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:DITTMER FLEMIG
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 1:200 UNIVERSITY AVE E
Mailing Address - Street 2:ZIP 010614
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-7937
Mailing Address - Country:US
Mailing Address - Phone:651-291-2848
Mailing Address - Fax:651-325-2221
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-291-2848
Practice Address - Fax:651-291-2848
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062150207X00000X
KYR3470207X00000X
NY303605207X00000X
390200000X
MN68501207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program