Provider Demographics
NPI:1235990474
Name:GRASS, PAIGE CATHERINE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:CATHERINE
Last Name:GRASS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 MANDERLY DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-1304
Mailing Address - Country:US
Mailing Address - Phone:248-534-3503
Mailing Address - Fax:
Practice Address - Street 1:880 MANDERLY DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-1304
Practice Address - Country:US
Practice Address - Phone:248-534-3503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant