Provider Demographics
NPI:1588764948
Name:FLEET, STEPHEN M (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:FLEET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:280 CHESTNUT ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:164 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2613
Practice Address - Country:US
Practice Address - Phone:413-794-2273
Practice Address - Fax:413-773-2841
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH20714207RC0000X
MA47690207RC0000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110052260AMedicaid
MA3102424Medicaid
MA110052260AMedicaid
MAJ13188Medicare PIN