Individual
DR. RICHARD THOMAS PRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8649 BAY COLONY DR, INDIANAPOLIS, IN 46234-2912
(317) 297-7519
Mailing address
8649 BAY COLONY DR, INDIANAPOLIS, IN 46234-2912
(317) 297-7519
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01053415A
IN
207R00000X
Internal Medicine Physician
01053415A
IN
207RG0100X
Gastroenterology Physician
01053415A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000600490
BLUE SHIELD
IN
05
—
200303800
—
IN
Enumeration date
03/07/2006
Last updated
02/23/2009
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