Provider Demographics
NPI:1821077199
Name:PATTERSON, PAIGE E (MD)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:E
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WESTMINSTER CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-4216
Mailing Address - Country:US
Mailing Address - Phone:540-665-5929
Mailing Address - Fax:540-665-1254
Practice Address - Street 1:300 WESTMINSTER CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-4216
Practice Address - Country:US
Practice Address - Phone:540-665-5929
Practice Address - Fax:540-665-1254
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101052632207QH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC00075OtherMEDICARE GROUP
WV0054444000Medicaid
VA210061OtherANTHEM
VA2119594OtherMAMSI
VA005616247Medicaid
VA41213OtherOPTIMA HEALTH SENTARA
VA502803OtherNCPPO
VAC00075OtherMEDICARE GROUP
VA41213OtherOPTIMA HEALTH SENTARA