MEDICARE: DR. MICHAEL ANDREW FLEMING DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	18251	MI

General Provider Information

NPI Number	:	1386618353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANDREW FLEMING DDS

Provider Business Mailing Address
First Line	:	830 STATE ST
Second Line	:
City	:	BOYNE CITY
State	:	MI
Zip	:	49712-9179
Country	:	US
Telephone Number	:	231-582-8000
Fax Number	:	231-582-6853

Provider Business Practice Location Address
First Line	:	830 STATE ST
Second Line	:
City	:	BOYNE CITY
State	:	MI
Zip	:	49712-9179
Country	:	US
Telephone Number	:	231-582-8000
Fax Number	:	231-582-6853

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	06/21/2010

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