Provider Demographics
NPI:1891766838
Name:FLEMING, SUSAN B (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:B
Last Name:FLEMING
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 1:4725 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5610
Mailing Address - Country:US
Mailing Address - Phone:520-888-2427
Mailing Address - Fax:520-888-8493
Practice Address - Street 1:4725 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-5610
Practice Address - Country:US
Practice Address - Phone:520-888-2427
Practice Address - Fax:520-888-8493
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-29
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14840MD174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0382450OtherBCBS OF AZ
AZ290552OtherAZ AHCCCS
AZ050056703OtherRR MEDICARE
AZ050056703OtherRR MEDICARE
AZAZ0382450OtherBCBS OF AZ