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Individual
DR. TRACY PRINCE
Active
Individual
DR. TRACY PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS010945L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019165970004
—
PA
01
—
1386391
HIGHMARK BS
PA
01
—
2525814
CIGNA
PA
01
—
50097247
CAPITAL BC
PA
01
—
7989331
AETNA
PA
01
—
P010738
GATEWAY HEALTH PLAN
PA
Enumeration date
07/27/2006
Last updated
03/17/2021
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