Provider Demographics
NPI:1588697304
Name:FLEMING, STEPHEN G (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:G
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:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-1332
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:194 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5000
Practice Address - Country:US
Practice Address - Phone:828-264-1100
Practice Address - Fax:828-264-0113
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30336207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8932632Medicaid
NC8932632Medicaid
206324Medicare ID - Type Unspecified