Provider Demographics
NPI:1316941065
Name:FLEISHMAN, SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:FLEISHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 MELROSE RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-1604
Mailing Address - Country:US
Mailing Address - Phone:910-615-3200
Mailing Address - Fax:910-615-3201
Practice Address - Street 1:3308 MELROSE RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-1604
Practice Address - Country:US
Practice Address - Phone:910-615-3200
Practice Address - Fax:910-615-3201
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500902103TC0700X, 207RS0012X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8932664Medicaid
NC2214108AMedicare ID - Type UnspecifiedPROVIDER NUMBER
NC8932664Medicaid