Marion R Prince, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

34004052 Issued in OH

Practice address

5195 Mayfield Rd
Suite 101
Lyndhurst, OH 44124-2464

Phone

(440) 442-0400

Fax

(440) 461-6005

NPI assigned

Jun 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physicians Link Center LLC

  • Emergency Medicine Physician
  • Elyria, OH
  • NPI 1235172925
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1790724250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5187 MAYFIELD RD STE 102",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242467",
            "telephone_number": "440-449-2809",
            "fax_number": "440-442-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5195 MAYFIELD RD",
            "address_2": "SUITE 101",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242464",
            "telephone_number": "440-442-0400",
            "fax_number": "440-461-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "MARION",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "34004052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790724250",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0572072",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Montina Denise Preston
• Preventive Healthcare Direct
• Preventive Healthcare Direct
• Preventive Medicine Group Inc
• Sharon Priesand, PA-C
• Progressive Lyndhurst LLC
• Progressive Lyndhurst LLC
• Provision Imaging of Northeast Ohio
• Anthony George Pucell, MD
• Ralph Siegenthaler Inc

• Internal Medicine Physician in Lyndhurst, OH
• Providers in Lyndhurst, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.