Individual
PAIGE M GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
853 N CHURCH ST STE 720C, SPARTANBURG, SC 29303-3003
(864) 560-6419
(864) 560-7498
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
29110
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291106
—
SC
05
—
5904997
—
NC
Enumeration date
07/13/2006
Last updated
01/07/2021
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