Provider Demographics
NPI:1710905542
Name:PRINCE, DOUGLAS H (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
Last Name:PRINCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-812-2501
Mailing Address - Fax:717-461-7178
Practice Address - Street 1:13515 WOLFE RD
Practice Address - Street 2:SUITE C
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-9346
Practice Address - Country:US
Practice Address - Phone:717-812-2501
Practice Address - Fax:717-461-7178
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050702207Q00000X
MDD0054469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5276041OtherAETNA
PA01069802OtherCAPITAL BLUE CROSS-WMG
PA164335OtherHIGHMARK BLUE SHIELD
PA001504048Medicaid
PA0723629000OtherAMERIHEALTH 65 PA
PA233295OtherMAMSI-WMG
PA30052OtherJOHNS HOPKINS
MD533542OtherCAREFIRST MD BCBS
PA80968OtherUNISON-WMG
PA1142416OtherAMERIHEALTH MERCY-WMG
PA36127OtherGEISINGER
PAP002831OtherGATEWAY-WMG
MD533542OtherCAREFIRST MD BCBS
PA36127OtherGEISINGER
PA80968OtherUNISON-WMG