Provider Demographics
NPI:1952894057
Name:THOMPSON, PAIGE PASQUALI (MD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:PASQUALI
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:PASQUALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:803-434-1335
Mailing Address - Fax:864-455-7807
Practice Address - Street 1:175 PATEWOOD DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3570
Practice Address - Country:US
Practice Address - Phone:864-797-1403
Practice Address - Fax:864-455-3884
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL52666208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics