Provider Demographics
NPI:1659067700
Name:DOREMUS, PAIGE
Entity Type:Individual
Prefix:MISS
First Name:PAIGE
Middle Name:
Last Name:DOREMUS
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 1:624 W HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2128
Mailing Address - Country:US
Mailing Address - Phone:253-330-3443
Mailing Address - Fax:
Practice Address - Street 1:624 W HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2128
Practice Address - Country:US
Practice Address - Phone:419-297-3293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-12
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator