| Doctor Name: | MYRON Y PRAWAK |
| NPI Number: | 1619193620 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | OS014021 |
| Business Practice Address: | 575 N River St Wilkes Barre, PA - 187640999 |
| Business Phone Number: | 5706963283 |
| Business Fax Number: | 5706963268 |
| Mailing Address: | Po Box 197, STATE COLLEGE |
| State: | PA |
| Postal Code: | 168040197 |
| Phone Number: | 8142356681 |
| Fax Number: | 8142351566 |
| NPI Enumeration Date: | 04/18/2007 |
| NPI Last Update Date: | 05/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | OS014021 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |