1508121518 NPI number — DR. MATTHEW F FLEMING MD

Table of content: DR. MATTHEW F FLEMING MD (NPI 1508121518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508121518 NPI number — DR. MATTHEW F FLEMING MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLEMING
Provider First Name:
MATTHEW
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1508121518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1390
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IOWA CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52244-1390
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-337-7284
Provider Business Mailing Address Fax Number:
319-337-7284

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
321 E MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52245
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-337-7284
Provider Business Practice Location Address Fax Number:
319-337-7284
Provider Enumeration Date:
07/06/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  A108234 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , with the licence number: 41957 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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