MEDICARE: MICHAEL ANTHONY FLEMING DC

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	111N00000X	Chiropractor	B764	NV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	V38633	OTHER	NV	MEDICARE PTAN

General Provider Information

NPI Number	:	1407934235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ANTHONY FLEMING DC

Provider Business Mailing Address
First Line	:	6330 S EASTERN AVE
Second Line	:	SUITE 8
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3168
Country	:	US
Telephone Number	:	702-796-1915
Fax Number	:	702-796-6151

Provider Business Practice Location Address
First Line	:	6330 S EASTERN AVE
Second Line	:	SUITE 8
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3168
Country	:	US
Telephone Number	:	702-796-1915
Fax Number	:	702-796-6151

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	04/07/2009

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