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General NPI Number Information
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NPI Number | 1548447477
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Entity Type | Individual
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Provider Name | KATHERINE E FLEMING-DUTRA M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 1645 TULLIE CIR NE
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City | ATLANTA
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State | GA
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Zip | 30329-2304
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Country | US
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Telephone | 404-785-7142
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Fax |
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Provider Business Mailing Address
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Address Line | 1645 TULLIE CIR NE
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City | ATLANTA
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State | GA
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Zip | 30329-2304
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Country | US
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Telephone | 404-785-7142
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2007017952
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2009010529
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5964
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License Number State | GA
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