Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | R7727 | MO |
N | 111NI0900X | Internist | R7727 | MO |
Y | 207RG0300X | Geriatric Medicine | R7727 | MO |
NPI | 1073565024 |
---|---|
Provider Name | David A Fleming |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65203-7637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 18/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A29009 | (02) |