Provider Demographics
NPI:1891759668
Name:GRICE, PATRICIA A (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:GRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8638 OLD TROY PIKE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-1051
Mailing Address - Country:US
Mailing Address - Phone:937-235-9575
Mailing Address - Fax:937-237-9562
Practice Address - Street 1:8638 OLD TROY PIKE
Practice Address - Street 2:SUITE 103
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-1051
Practice Address - Country:US
Practice Address - Phone:937-235-9575
Practice Address - Fax:937-237-9562
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35057543G207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0812679Medicaid
08182941Medicare PIN
OHE30338Medicare UPIN
OH0812679Medicaid