Donald G Prouty

NPI #1164012019 in Ithaca, Michigan

Provider Information

NPI Number: 1164012019
Entity Type: Organization
Organization Name: Donald G Prouty
Primary Specialty: Family Medicine
Enumeration Date: Jan 25, 2021
Last Updated: Feb 5, 2021

Practice Location

Address: 820 N PINE RIVER ST
City: Ithaca
State: Michigan
ZIP Code: 48847-1118
Phone: (989) 330-1492

Authorized Official

Name: DONALD G PROUTY, MD
Title: OWNER
Phone: (989) 330-1492

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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