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General NPI Number Information
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NPI Number | 1013364793
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Entity Type | Individual
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Provider Name | PAIGE WOODHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 169 ASHLEY AVE ROOM 202 MAIN HOSPITAL MSC333
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City | CHARLESTON
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State | SC
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Zip | 29425-9080
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Country | US
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Telephone | 843-792-1086
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Fax |
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Provider Business Mailing Address
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Address Line | 925 CLEVELAND ST UNIT 193
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City | GREENVILLE
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State | SC
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Zip | 29601-4548
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Country | US
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Telephone | 910-280-4287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | LL39466
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License Number State | SC
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