Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD421632 | PA |
Y | 208600000X | Surgeon | MD421632 | PA |
NPI | 1003014788 |
---|---|
Provider Name | Dr. Jose Manuel Prince |
First Address | Pittsburgh, PA 15217-2505 |
Second Address | Pittsburgh, PA 15217-2505 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 08/07/2007 |