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General NPI Number Information
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NPI Number | 1780645093
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Entity Type | Individual
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Provider Name | CANDICE MICHELLE YU-FLEMING MD
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Gender | Female
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 3630 WILLOWCREEK RD
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City | PORTAGE
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State | IN
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Zip | 46368-5075
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Country | US
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Telephone | 219-364-3700
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Fax | 219-364-3610
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Provider Business Mailing Address
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Address Line | 2022 KELLE DR
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City | CHESTERTON
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State | IN
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Zip | 46304-8708
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Country | US
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Telephone | 219-364-3616
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Fax | 219-364-3610
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01058114
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License Number State | IN
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