Individual
DR. MICHAEL EDWARD PRATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1760 MCCULLOCH BLVD N, STE. 100, LAKE HAVASU CITY, AZ 86403-6559
(928) 854-5368
(928) 854-4462
Mailing address
1760 MCCULLOCH BLVD N, STE. 100, LAKE HAVASU CITY, AZ 86403-6559
(928) 854-5368
(928) 854-4462
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
28430
AZ
207YX0602X
Otolaryngic Allergy Physician
28430
AZ
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
28430
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
515877
—
AZ
Enumeration date
05/03/2006
Last updated
03/27/2008
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