Basic Information
Provider Information
NPI: 1073565024
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FLEMING
FirstName: DAVID
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 843966
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641843966
CountryCode: US
TelephoneNumber: 5738843300
FaxNumber: 5738840943
Practice Location
Address1: 101 S FAIRVIEW RD
Address2:  
City: COLUMBIA
State: MO
PostalCode: 652037637
CountryCode: US
TelephoneNumber: 5738824464
FaxNumber: 5738848142
Other Information
ProviderEnumerationDate: 05/17/2006
LastUpdateDate: 04/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XR7727MON Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0300XR7727MOY Allopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine

No ID Information.


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