Healthcare Provider Details

I. General information

NPI: 1043431406
Provider Name (Legal Business Name): RONALD CHEVINE FLEMING D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 LOCUST AVENUE
FAIRMONT WV
26554-9643
US

IV. Provider business mailing address

1325 LOCUST AVE
FAIRMONT WV
26554-1435
US

V. Phone/Fax

Practice location:
  • Phone: 304-367-7100
  • Fax: 304-799-2229
Mailing address:
  • Phone: 304-367-7100
  • Fax: 304-799-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2256
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5850
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number02932
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: