Provider Demographics
NPI:1144611799
Name:WELCH, PAIGE (PA)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:GIVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:301-271-3535
Mailing Address - Fax:301-271-2650
Practice Address - Street 1:52 WATER ST
Practice Address - Street 2:
Practice Address - City:THURMONT
Practice Address - State:MD
Practice Address - Zip Code:21788-1912
Practice Address - Country:US
Practice Address - Phone:301-271-3535
Practice Address - Fax:301-271-2650
Is Sole Proprietor?:No
Enumeration Date:2015-02-17
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA064526363AM0700X
MDC005682363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD926580504Medicaid
MD926580505Medicaid
MD451LMedicare PIN
MDCD8143Medicare PIN
MD926580506Medicare PIN