Provider Demographics
NPI:1952341653
Name:FLEMING FRUCI, CAROLYN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:MARIE
Last Name:FLEMING FRUCI
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:CAROLYN
Other - Middle Name:M
Other - Last Name:FRUCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:203 PLYMOUTH AVE STE 702
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-4300
Mailing Address - Country:US
Mailing Address - Phone:508-679-4239
Mailing Address - Fax:
Practice Address - Street 1:400 SENTARA CIR STE 320
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5716
Practice Address - Country:US
Practice Address - Phone:757-345-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26871174400000X
VA0101239948207RP1001X, 207RC0200X
MA155125207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No174400000XOther Service ProvidersSpecialist
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG70864Medicare UPIN