Robert Tyler Prince, MS, CGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

7201000255 Issued in MI

Practice address

44555 Woodward Ave Ste 404
Pontiac, MI 48341-5036

Phone

(947) 232-7112

Fax

(248) 858-3648

NPI assigned

Oct 11, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Tyler Prince Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1720869100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE STE 404",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415036",
            "telephone_number": "947-232-7112",
            "fax_number": "248-858-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44555 WOODWARD AVE STE 404",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415036",
            "telephone_number": "947-232-7112",
            "fax_number": "248-858-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "ROBERT",
        "middle_name": "TYLER",
        "credential": "MS, CGC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MI",
            "license": "7201000255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYLER",
            "last_name": "PRINCE",
            "credential": "MS, CGC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Genetic Counselor (M.S.) in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Genetic Counselor (M.S.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.