Healthcare Provider Details

I. General information

NPI: 1023921129
Provider Name (Legal Business Name): JULIUS PRINCE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 COLUMBIA RD NW
WASHINGTON DC
20001-3802
US

IV. Provider business mailing address

740 COLUMBIA RD NW
WASHINGTON DC
20001-3802
US

V. Phone/Fax

Practice location:
  • Phone: 202-344-6894
  • Fax:
Mailing address:
  • Phone: 202-617-0186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number1710750617
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: