Provider Demographics
NPI:1700865011
Name:PAIGE, SOPHIA LORRAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:LORRAINE
Last Name:PAIGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3125 SPRINGBANK LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-3345
Mailing Address - Country:US
Mailing Address - Phone:704-341-1103
Mailing Address - Fax:704-341-3460
Practice Address - Street 1:3125 SPRINGBANK LN
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3345
Practice Address - Country:US
Practice Address - Phone:704-341-1103
Practice Address - Fax:704-341-3460
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600668207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8965008Medicaid
G28975Medicare UPIN