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Individual

MR. DONALD GRAHAM PROUTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
820 N PINE RIVER ST, ITHACA, MI 48847
(989) 875-3722
(989) 875-3732
Mailing address
820 N PINE RIVER ST, ITHACA, MI 48847
(989) 875-3722
(989) 875-3732

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301041429
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0802900501
BCBSM
MI
01
0983153
HEALTHPLUS COMMERCIAL
MI
01
1009879
MCLAREN HEALTH PLAN
MI
01
200000005847
PHP COMMERCIAL
MI
05
4563131-10
MI
Enumeration date
06/07/2006
Last updated
12/15/2022
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