MEDICARE: DONALD H PRITCHARD MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME65084	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417147638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD H PRITCHARD MD PA

Provider Business Mailing Address
First Line	:	PO BOX 1442
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34423-1442
Country	:	US
Telephone Number	:	443-869-5365
Fax Number	:

Provider Business Practice Location Address
First Line	:	9030 W FORT ISLAND TRL
Second Line	:	SUITE 3
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-2412
Country	:	US
Telephone Number	:	352-564-2077
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DONALD H PRITCHARD
Credential	:	M.D., PA
Telephone Number	:	443-869-5365

Provider Enumeration Date	:	07/25/2007
Last Update Date	:	09/21/2008

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