| Gary L Prah, Md | |
|
1318 Main St Lafayette IN 47901-1550 | |
| (765) 742-5254 | |
| (765) 742-4991 |
| Full Name | Gary L Prah, Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 1318 Main St, Lafayette, Indiana |
| Authorized Official Name and Position | Martha K Miller (DIRECTOR OF BILLING) |
| Authorized Official Contact | 7654465286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary L Prah, Md Po Box 4699 Lafayette IN 47903-4699 Ph: (765) 449-2732 | Gary L Prah, Md 1318 Main St Lafayette IN 47901-1550 Ph: (765) 742-5254 |
| NPI Number | 1720253255 |
|---|---|
| Provider Enumeration Date | 04/25/2008 |
| Last Update Date | 04/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720253255 | NPI | - | NPPES |
| 200107480I | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Indiana) | Primary |
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