Provider Demographics
NPI:1306327945
Name:FLEMING, DONALD DAVID
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:DAVID
Last Name:FLEMING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DONALD DAVID FLEMING
Mailing Address - Street 2:506 SUMMIT DRIVE
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047
Mailing Address - Country:US
Mailing Address - Phone:443-371-3256
Mailing Address - Fax:
Practice Address - Street 1:DAVE FLEMING
Practice Address - Street 2:418 S MAIN STREET
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:443-371-3256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP8838101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health