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General NPI Number Information
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NPI Number | 1851383772
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Entity Type | Individual
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Provider Name | SHERNETTE D. PRINCE M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 850 CHISHOLM AVE
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City | ODENTON
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State | MD
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Zip | 21113
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Country | US
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Telephone | 301-453-2233
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Fax |
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Provider Business Mailing Address
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Address Line | 9466 GEORGIA AVE # 1295
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City | SILVER SPRING
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State | MD
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Zip | 20910-1456
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Country | US
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Telephone | 301-453-2233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0062173
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License Number State | MD
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