Individual
RICHMOND PRATER ALLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1330 BOILING SPRINGS RD, SUITE 2100, SPARTANBURG, SC 29303-4201
(864) 573-2145
(864) 573-2644
Mailing address
PO BOX 484, EASLEY, SC 29641-0484
(864) 546-4497
(864) 546-4506
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23773
SC
208VP0000X
Pain Medicine Physician
23773
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237737
—
SC
01
—
P00386918
MEDICARE RAILROAD PTAN #
GA
Enumeration date
05/16/2006
Last updated
02/20/2017
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