Provider Demographics
NPI:1396408860
Name:PAIGE, CARLTON MORRIS JR
Entity Type:Individual
Prefix:
First Name:CARLTON
Middle Name:MORRIS
Last Name:PAIGE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411C HAYES ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-7523
Mailing Address - Country:US
Mailing Address - Phone:202-421-9664
Mailing Address - Fax:
Practice Address - Street 1:2004 SAVANNAH ST SE APT 102
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7527
Practice Address - Country:US
Practice Address - Phone:202-421-1590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant