Basic Information
| Provider Information | |||||||||
| NPI: | 1700264538 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRINCE | ||||||||
| FirstName: | GRACE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1607 VILLAGE CROSSING DR | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275177577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2768063108 | ||||||||
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| Practice Location | |||||||||
| Address1: | 125 MACNIDER HL | ||||||||
| Address2: | CAMPUS BOX #7005 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275997005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199664468 | ||||||||
| FaxNumber: | 9198435945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2015 | ||||||||
| LastUpdateDate: | 06/03/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | 149070 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | 207R00000X | 209971 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.