MEDICARE: PAIGE PRIMM PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	0010-06698	NC

General Provider Information

NPI Number	:	1750839395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE PRIMM PA-C

Provider Business Mailing Address
First Line	:	307 E THOM ST
Second Line	:
City	:	CHINA GROVE
State	:	NC
Zip	:	28023-2363
Country	:	US
Telephone Number	:	704-855-5200
Fax Number	:	704-855-5239

Provider Business Practice Location Address
First Line	:	307 E THOM ST
Second Line	:
City	:	CHINA GROVE
State	:	NC
Zip	:	28023-2363
Country	:	US
Telephone Number	:	704-855-5200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2016
Last Update Date	:	01/26/2022

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Directions to “ PAIGE PRIMM PA-C” Practice Location

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