Provider Demographics
NPI:1942017553
Name:FLEMING, MARY F (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:F
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14073 LOTUS LN APT 934
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-7402
Mailing Address - Country:US
Mailing Address - Phone:410-227-8876
Mailing Address - Fax:
Practice Address - Street 1:3905 FAIR RIDGE DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-2906
Practice Address - Country:US
Practice Address - Phone:703-877-0580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPH200005049183500000X
VA0202221911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist