Provider Demographics
NPI:1598767444
Name:PRATER, CHRISTOPHER D (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:D
Last Name:PRATER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LEE PARKWAY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6708
Mailing Address - Country:US
Mailing Address - Phone:423-305-1508
Mailing Address - Fax:423-305-1514
Practice Address - Street 1:105 LEE PARKWAY DR
Practice Address - Street 2:SUITE A
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6708
Practice Address - Country:US
Practice Address - Phone:423-305-1508
Practice Address - Fax:423-305-1514
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN8547207Q00000X, 101YA0400X, 101YM0800X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I084762OtherMEDICARE PTAN
TN4256026OtherBCBS PIN
TN3370066OtherMEDICARE GROUP
TN4256026OtherBCBS PIN