Pruette, Cozumel Southern
Pruette, Cozumel Southern is an individual health care provider with primary practice located at 200 N Wolfe St Room 3055, Baltimore MD 21287-0011. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Nephrology. Allopathic & Osteopathic Physicians / Pediatric Nephrology is her primary health care specialty. Pruette, Cozumel Southern can be contacted via phone (410) 955-2467.Contact Information
Primary practice address
200 N Wolfe St Room 3055
Baltimore MD 21287-0011
Phone: (410) 955-2467
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | P20254 | Maryland |
| Allopathic & Osteopathic Physicians / Pediatric Nephrology | 2080P0210X | D67656 | Maryland |
Profile Details
| NPI number | 1295887750 |
|---|---|
| LBN Legal business name | Pruette, Cozumel Southern |
| Credentials | MD, MHS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 17th, 2007 |
| Last updated | Mar 1st, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295887750 | NPPES |
| Maryland | MEDICAID | 055174100 |
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