Provider Demographics
NPI:1831179142
Name:FLEMMING, DONALD JOEL (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:JOEL
Last Name:FLEMMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:800-243-1455
Mailing Address - Fax:
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:800-243-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4174632085R0202X, 2085R0202X
KYTP5842085R0202X
KY581832085R0202X
NY21611812085R0202X
OH35080161F2085R0202X
VA01010401662085R0202X
WAMD432462085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072853N7WMedicare PIN
PA19601560001Medicare PIN
VA07231679Medicaid
DE1000033860Medicaid
VA10120110Medicaid
MD192MH385Medicare PIN
OH4062321Medicare PIN
H51967Medicare UPIN
PA19601560001Medicare PIN
VA07231636Medicaid
OH4062322Medicare PIN
VA07231687Medicaid
VA10120209Medicaid
PA072853N7WMedicare PIN
MD193MJ748Medicare PIN