Healthcare Provider Details

I. General information

NPI: 1073408803
Provider Name (Legal Business Name): PAIGE MARIE BERMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30055 NORTHWESTERN HWY STE 220
FARMINGTON HILLS MI
48334-3275
US

IV. Provider business mailing address

30055 NORTHWESTERN HWY STE 220
FARMINGTON HILLS MI
48334-3275
US

V. Phone/Fax

Practice location:
  • Phone: 248-865-9898
  • Fax:
Mailing address:
  • Phone: 248-865-9898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704390044
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704390044
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704390044
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: