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General NPI Number Information
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NPI Number | 1982299871
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Entity Type | Individual
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Provider Name | PAIGE MADISYN THEUER PA-C
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Gender | Female
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 4101 MACON POND RD
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City | RALEIGH
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State | NC
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Zip | 27607-6319
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Country | US
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Telephone | 919-781-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 910 TRYON HILL DR APT 448
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City | RALEIGH
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State | NC
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Zip | 27603-1898
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Country | US
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Telephone | 920-379-8213
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5139
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-14654
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License Number State | NC
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