Provider Demographics
NPI:1891739116
Name:JOSLIN-PAGE, JUDITH A (DO)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:JOSLIN-PAGE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:A
Other - Last Name:PAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:35125 GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3211
Mailing Address - Country:US
Mailing Address - Phone:248-476-1540
Mailing Address - Fax:248-476-7123
Practice Address - Street 1:35125 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-3211
Practice Address - Country:US
Practice Address - Phone:248-476-1540
Practice Address - Fax:248-476-7123
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010944207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5631269OtherBLUE CROSS
MIC3118OtherMCARE
MI4514498OtherAETNA
MIP84100OtherBLUE CROSS
MI140154OtherCARE CHOICES
MI4514498OtherAETNA
MIP84100OtherBLUE CROSS
F77780Medicare UPIN