Provider Demographics
NPI:1316053143
Name:FLETCHER, VALERIE P (MD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:P
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 18TH ST
Mailing Address - Street 2:SIUTE B40
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1536
Mailing Address - Country:US
Mailing Address - Phone:706-649-9955
Mailing Address - Fax:706-649-9958
Practice Address - Street 1:500 18TH ST
Practice Address - Street 2:SIUTE B40
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1536
Practice Address - Country:US
Practice Address - Phone:706-649-9955
Practice Address - Fax:706-649-9958
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081729207RI0200X
GA058471207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2363339Medicaid
OH2363339Medicaid
OHH74371Medicare UPIN
GAH74371Medicare UPIN