Provider Demographics
NPI:1912976507
Name:FLEMING, DONALD R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:FLEMING
Suffix:JR
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 1:801 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3607
Mailing Address - Country:US
Mailing Address - Phone:304-637-3640
Mailing Address - Fax:304-637-3644
Practice Address - Street 1:801 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3607
Practice Address - Country:US
Practice Address - Phone:304-637-3640
Practice Address - Fax:304-637-3644
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045209A207RH0003X
WV23209207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200078200AMedicaid
IN200078200AMedicaid
INF29333Medicare UPIN
7387851Medicare PIN
IN441910Medicare PIN
IN114620WWMedicare PIN
IN830007836Medicare PIN