Provider Demographics
NPI:1689833162
Name:PAIGE, CYNTHIA M (NP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:M
Last Name:PAIGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35046 WOODWARD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-0932
Mailing Address - Country:US
Mailing Address - Phone:248-647-9860
Mailing Address - Fax:248-647-9864
Practice Address - Street 1:35046 WOODWARD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-0932
Practice Address - Country:US
Practice Address - Phone:248-647-9860
Practice Address - Fax:248-647-9864
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704178240363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology