Provider Demographics
NPI:1699893867
Name:PAGE, CATHERINE ANNETTE (DPM)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:ANNETTE
Last Name:PAGE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2569
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-0569
Mailing Address - Country:US
Mailing Address - Phone:434-792-7348
Mailing Address - Fax:434-792-7348
Practice Address - Street 1:601 S MAIN STREET
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-3827
Practice Address - Country:US
Practice Address - Phone:434-792-7348
Practice Address - Fax:434-792-7348
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000886213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0093457Medicaid
VA1B085313OtherANTHEM
VA4408790001Medicare PIN
480000495Medicare ID - Type Unspecified
VA1B085313OtherANTHEM
VA0093457Medicaid
VA480000495Medicare PIN