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Individual

DR. MICHELLE MARIE PRINCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5153 N 9TH AVE, PENSACOLA, FL 32504-8785
(850) 416-1575
(850) 416-1302
Mailing address
301 N 8TH ST DEPT OF, SPRINGFIELD, IL 62701-1041
(217) 757-6535

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
LT 3316
NH
207XP3100X
Pediatric Orthopaedic Surgery Physician
036.131686
IL
207XP3100X
Pediatric Orthopaedic Surgery Physician
L6587
TX
207XP3100X
Pediatric Orthopaedic Surgery Physician
LT 3316
NH
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
ME143244
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1624231-04
TX
01
1624231-05
MEDICAID CSHCN - ROT
TX
05
1624231-06
TX
01
162423103
MEDICAID CSHCN
TX
01
8K8547
BCBS INDIVIDUAL #
TX
Enumeration date
02/13/2006
Last updated
01/13/2020
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