Provider Demographics
NPI:1699973537
Name:EASTMAN, PAIGE (CPM)
Entity type:Individual
Prefix:MS
First Name:PAIGE
Middle Name:
Last Name:EASTMAN
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MAXFIELD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5229
Mailing Address - Country:US
Mailing Address - Phone:508-979-8887
Mailing Address - Fax:
Practice Address - Street 1:240 MAXFIELD ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5229
Practice Address - Country:US
Practice Address - Phone:508-979-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
01030018176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
01030018OtherC.P.M. NUMBER
MAQ04746OtherBCBS PROVIDER NUMBER