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Individual

KEITH W FLEMING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
329 MAINE STREET, BRUNSWICK, ME 04011-3310
(207) 373-2000
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-5363

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
017401
ME
2085R0202X
Diagnostic Radiology Physician
226212
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432592899
ME
01
P00409720
RR MEDICARE
ME
Enumeration date
08/22/2006
Last updated
08/04/2010
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