Healthcare Provider Details

I. General information

NPI: 1306338025
Provider Name (Legal Business Name): AUBREY FLEMING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 MIDDLETOWN CMNS STE 163
FAIRMONT WV
26554-2882
US

IV. Provider business mailing address

1247 SUNCREST TOWN CENTRE DR
MORGANTOWN WV
26505-1876
US

V. Phone/Fax

Practice location:
  • Phone: 304-599-8000
  • Fax: 304-599-8003
Mailing address:
  • Phone: 304-599-8000
  • Fax: 304-599-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL52190
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number30749
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: