Individual
SHANNON M SAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-2372
(508) 334-3408
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
018074
NY
363A00000X
Physician Assistant
Primary
PA6032
MA
Other
Enumeration date
11/07/2014
Last updated
03/30/2021
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