Healthcare Provider Details

I. General information

NPI: 1952361081
Provider Name (Legal Business Name): DAVID RICHARD FLEISHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF MISSOURI SCHOOL OF MEDICINE, DEPT OF CHILD HEALTH. 1 HOSPITAL DRIVE
COLUMBIA MO
65212
US

IV. Provider business mailing address

705 CENTENNIAL CT
COLUMBIA MO
65203-2993
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-3996
  • Fax: 573-884-4277
Mailing address:
  • Phone: 573-443-1189
  • Fax: 573-884-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberR7PO1
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: