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NPI Code Detail

MEDICARE: GORGIO DEMETRIUS FLEMING CPRS

MEDICARE: GORGIO DEMETRIUS FLEMING CPRS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistAPS.004982OH
2101YA0400XAddiction (Substance Use Disorder) CounselorCDCA.194254OH

General Provider Information

NPI Number : 1356198881
Entity Type Code : Individual
Provider Name (Legal Business Name) : GORGIO DEMETRIUS FLEMING CPRS
Provider Business Mailing Address
First Line : 1791 ALUM CREEK DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1757
Country : US
Telephone Number : 614-445-8131
Fax Number :
Provider Business Practice Location Address
First Line : 1791 ALUM CREEK DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1757
Country : US
Telephone Number : 614-445-8131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2024
Last Update Date : 02/02/2026

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