MEDICARE: MRS. STEPHANIE FLEMING CPT, CMA

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
1	202K00000X	Phlebology Physician	D3N3L8B7	GA

General Provider Information

NPI Number	:	1780327973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE FLEMING CPT, CMA

Provider Business Mailing Address
First Line	:	2330 SCENIC HWY S
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-3115
Country	:	US
Telephone Number	:	678-562-5244
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 SCENIC HWY S
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-3115
Country	:	US
Telephone Number	:	678-562-5244
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	04/15/2022

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