Individual
MICHAEL DALE PROSPERIE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 HOSPITAL DR, OAKDALE, LA 71463-3035
(800) 893-9698
Mailing address
505 PLEASURE LN, THIBODAUX, LA 70301-3737
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
011513
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174629
—
LA
Enumeration date
05/08/2006
Last updated
07/08/2007
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