Provider Demographics
NPI:1457383663
Name:FLEMING, MARK T (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:T
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5900 LAKE WRIGHT DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-1871
Mailing Address - Country:US
Mailing Address - Phone:757-213-5700
Mailing Address - Fax:757-213-5701
Practice Address - Street 1:3000 COLISEUM DR
Practice Address - Street 2:SUITE 104
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5963
Practice Address - Country:US
Practice Address - Phone:757-827-9400
Practice Address - Fax:757-827-9320
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
VA0101240180207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10010471OtherOPTIMA
VA010294959Medicaid
VAP00343325OtherRAILROAD MEDICARE
VAP00343325OtherRAILROAD MEDICARE
VA010294959Medicaid
VABF9787358OtherDEA