Individual
MELVIN JAY PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
GENNESARET FREE CLINIC 615 N ALABAMA ST, SUITE 136, INDIANAPOLIS, IN 46204
(317) 639-5645
Mailing address
9510 N. KISSELL RD., ZIONSVILLE, IN 46077
(317) 507-3986
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01039882A
IN
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
01039882A
IN
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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