Healthcare Provider Details
I. General information
NPI: 1144611799
Provider Name (Legal Business Name): PAIGE WELCH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/17/2015
Last Update Date: 07/29/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
52 WATER ST
THURMONT MD
21788-1912
US
IV. Provider business mailing address
3421 CONCORD RD
YORK PA
17402-9001
US
V. Phone/Fax
- Phone: 301-271-3535
- Fax: 301-271-2650
- Phone: 301-271-3535
- Fax: 301-271-2650
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | MA064526 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | C005682 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: