Provider Demographics
NPI:1194775643
Name:PRYCE, ALISON P (MD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:P
Last Name:PRYCE
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 1:3102 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120
Mailing Address - Country:US
Mailing Address - Phone:216-283-6303
Mailing Address - Fax:216-464-2444
Practice Address - Street 1:4400 RENAISSANCE PKWY
Practice Address - Street 2:SUITE L
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-5763
Practice Address - Country:US
Practice Address - Phone:216-464-8484
Practice Address - Fax:216-464-2444
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0532602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0786109Medicaid
OH0786109Medicaid
OH4012246Medicare ID - Type Unspecified