Provider Demographics
NPI:1134529373
Name:PLUMB, PAIGE
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:PLUMB
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 1:88 W WARWICK AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-3871
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 W WARWICK AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-3871
Practice Address - Country:US
Practice Address - Phone:401-615-2220
Practice Address - Fax:401-615-2424
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI0859174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian