1033534979 NPI number — MATTHEW FLEMING, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033534979 NPI number — MATTHEW FLEMING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MATTHEW FLEMING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1033534979
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3970 MOUNTVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43220-4856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-264-5851
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1200 W 5TH AVE
Provider Second Line Business Practice Location Address:
SUITE 102B
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43212-2503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-264-5851
Provider Business Practice Location Address Fax Number:
614-706-6066
Provider Enumeration Date:
03/02/2014

Additional Information

Authorized Official

Authorized Official Last Name:
FLEMING
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
614-264-5851

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  E.0602071-SUPV , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com