Provider Demographics
NPI:1588662142
Name:FLEMING, THOMAS E (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:FLEMING
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:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44871-0378
Mailing Address - Country:US
Mailing Address - Phone:419-609-1112
Mailing Address - Fax:419-609-1123
Practice Address - Street 1:2500 W STRUB RD
Practice Address - Street 2:SUITE 350
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5390
Practice Address - Country:US
Practice Address - Phone:419-502-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070175207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000140613OtherANTHEM BLUE CROSS
OH2353206Medicaid
OH000000140613OtherANTHEM BLUE CROSS
OH070011916Medicare ID - Type UnspecifiedRR MEDICARE
OH$$$$$$$$$002OtherMEDICAL MUTUAL OF OHIO
OHG51576Medicare UPIN