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Individual

MARK D PRINCE

Active
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Individual

MARK D PRINCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2848A
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00356
WINHEALTH PARTNERS
WY
01
—
110187400
RAILROAD MEDICARE
WY
05
—
114388300
—
WY
01
—
308045
BLUE SHIELD
WY
01
—
82009A032
WPS TRIWEST
WY
Enumeration date
07/25/2006
Last updated
04/07/2021
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