| Doctor Name: | TODD A PRYOR |
| NPI Number: | 1629090907 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 5101009393 |
| Business Practice Address: | 418 Washington St Lakeview, MI - 488509806 |
| Business Phone Number: | 9893527211 |
| Business Fax Number: | |
| Mailing Address: | Po Box 3567, GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495013567 |
| Phone Number: | 6169751845 |
| Fax Number: | 6162850846 |
| NPI Enumeration Date: | 07/24/2006 |
| NPI Last Update Date: | 09/23/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207PE0004X |
| License Number: | 5101009393 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | Emergency Medical Services |
| Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |