Provider Demographics
NPI:1609965029
Name:PAGE, ROBERT E (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
Last Name:PAGE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E MAIN ST
Mailing Address - Street 2:PO BOX 1187
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-2310
Mailing Address - Country:US
Mailing Address - Phone:508-943-8895
Mailing Address - Fax:508-949-2187
Practice Address - Street 1:27 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-2310
Practice Address - Country:US
Practice Address - Phone:508-943-8895
Practice Address - Fax:508-949-2187
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2305111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPAY45208Medicare ID - Type Unspecified
MAU64614Medicare UPIN