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Individual

DR. MICHAEL L. PRYCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1104 COMMONS AVE, CORTLAND, NY 13045-1643
(607) 758-3750
(607) 758-3754
Mailing address
134 HOMER AVE, CORTLAND, NY 13045-1206
(607) 758-8019
(607) 758-8210

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
280178
NY
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
35-04-2582-P
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04236155
NY
05
0548401
OH
01
34-1522369
FEDERAL TAX ID #
OH
01
34152236900
WORKERS COMP. #
OH
Enumeration date
07/07/2005
Last updated
05/01/2018
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