Healthcare Provider Details

I. General information

NPI: 1992633226
Provider Name (Legal Business Name): PAIGE ELIZABETH HARRIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14797 DIX TOLEDO RD
SOUTHGATE MI
48195-2507
US

IV. Provider business mailing address

24160 COLONIAL DR
WOODHAVEN MI
48183-3725
US

V. Phone/Fax

Practice location:
  • Phone: 734-887-6686
  • Fax:
Mailing address:
  • Phone: 734-752-2952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: