Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 35039265 | OH |
NPI | 1396803417 |
---|---|
Provider Name | Douglas C Prince |
First Address | Dayton, OH 45475-1084 |
Second Address | Dayton, OH 45404-1898 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 08/07/2007 |