Provider Demographics
NPI:1093758534
Name:NOLTE, PAIGE B (MD)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:B
Last Name:NOLTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:JOCELYN
Other - Middle Name:PAIGE
Other - Last Name:BEATTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 BRANDON AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-0777
Mailing Address - Country:US
Mailing Address - Phone:434-924-5362
Mailing Address - Fax:434-654-7752
Practice Address - Street 1:550 BRANDON AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0777
Practice Address - Country:US
Practice Address - Phone:434-924-5362
Practice Address - Fax:434-654-7752
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238096208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I31988Medicare UPIN
VAP00613101Medicare PIN
VA017515M54Medicare PIN